NPIMap

Individual provider Active NPI

Samantha Jacobs

  • Family Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1508402959
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021890 Issued in PA
Practice address
4815 Liberty Ave Ste 340
Pittsburgh, PA 15224-2156
Phone
(412) 681-4401
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 95013319 CA
Family Nurse Practitioner 363LF0000X SP021890 PA Primary

Addresses

Primary practice location

4815 Liberty Ave Ste 340
Pittsburgh, PA 15224-2156

Mailing address

247 Morewood Ave
Pittsburgh, PA 15213-1861
Phone (412) 622-0290

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scrouse309629@direct.ahn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200616002359 PA Practitioner - Nurse Practitioner 5294157475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allegheny Clinic Medical OncologyGroup PAC ID 9739077561, 97 clinicians

Practice addresses (Care Compare)

4815 Liberty Ave
Suite 340
Pittsburgh, PA 15224-2156
Phone (412) 681-4401

Hospital & facility affiliations

  • West Penn Hospital Hospital, Pittsburgh, PA, CCN 390090
  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050
  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267
  • Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265

Merit-based Incentive Payment System (MIPS)

Final score
79.53 of 100Reported as group
Quality
73.42
Promoting interoperability
100
Improvement activities
40
Cost
47.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013319CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Medical Oncology Single Specialty CurrentSince Jun 8, 2020 Accepting new patients
Windber Hospital, Inc. Single Specialty Past Accepting new patients

Locations

1 Nolte Dr
Kittanning, PA 16201
Phone (724) 543-8109

247 Morewood Ave
Pittsburgh, PA 15213
Phone (412) 622-0290

4815 Liberty Ave
Ste 340
Pittsburgh, PA 15224
Phone (412) 621-3211

Interoperability endpoints

  • Direct secure messaging: scrouse309629@direct.ahn.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1508402959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 MOREWOOD AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131861",
            "telephone_number": "412-622-0290",
            "fax_number": "412-681-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 340",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-681-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013319",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scrouse309629@direct.ahn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4815 Liberty Ave Ste 340",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152242156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.