Individual provider Active NPI

Samantha A Agar, M.D.

  • Family Medicine Physician
  • Decatur, IL
National Provider Identifier
1568024867
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125075143 Issued in IL
Practice address
102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379
Phone
(217) 872-3800
Fax
(217) 872-0849
NPI assigned
Jul 8, 2019
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125075143 IL Primary

Addresses

Primary practice location

102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379

Mailing address

102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379
Phone (217) 872-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220826002775 IL Practitioner - Family Practice 4880929900 Reassigns benefits to 1 organization
I20251024002880 IN Practitioner - Family Practice 4880929900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Methodist Hospitals IncGroup PAC ID 9638063894, 131 clinicians

Practice addresses (Care Compare)

102 W Kenwood Ave
Suite 100
Decatur, IL 62526-4379
Phone (217) 872-3800

200 E 89TH Ave
Merrillville, IN 46410-7318
Phone (219) 738-5330

751 E 81St Ave
Methodist Physicians Group
Merrillville, IN 46410-5538
Phone (219) 791-9476

8701 Broadway
Merrillville, IN 46410-7035
Phone (219) 738-4926

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125075143ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 1, 2022 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Oct 1, 2025 Accepting new patients
The Methodist Hospitals, Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

27350 Network Pl
Chicago, IL 60673

102 W Kenwood Ave
Ste 100
Decatur, IL 62526
Phone (217) 872-3800

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

200 E 89th Ave
Merrillville, IN 46410
Phone (219) 738-4926

751 E 81st Ave
Merrillville, IN 46410
Phone (219) 738-6600

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

Organizations & group practices 4

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

Hospital & facility affiliations 4

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1568024867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE STE 100",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264379",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE STE 100",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264379",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAR",
        "first_name": "SAMANTHA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125075143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.