Samantha Nicole Coburn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C07752 Issued in MD

Practice address

3414 Olandwood CT
Olney, MD 20832-1384

Phone

(301) 774-0500

Fax

(301) 774-7338

NPI assigned

Oct 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Samantha Nicole Gasior Former name

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048
• Medstar Montgomery Medical Center Hospital, Olney, MD, CCN 210018
• Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgasior793670@direct.hopkinsmedicine.org

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.

• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Olney, MD
  • NPI 1487093167
  Medicare reassignment Care Compare group NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Manassas, VA
  • NPI 1265871958

  DC

  Medicare reassignment
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, VA
  • NPI 1063393833
  NPD
• Centers for Advanced Orthopaedics LLC

  • Durable Medical Equipment & Medical Supplies
  • Rockville, MD
  • NPI 1295614238
  NPD (past)
• Orthopaedic Associates of Central Maryland, PA

  • Orthopaedic Surgery Physician
  • Columbia, MD
  • NPI 1023269396
  NPD (past)

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

• Holy Cross Health, Inc.

  dba Holy Cross Germantown Hospital

  • General Acute Care Hospital
  • Germantown, MD
  • NPI 1245655638
  Care Compare affiliation
• Howard County General Hospital, Inc,

  dba Johns Hopkins Howard County Medical Center

  • General Acute Care Hospital
  • Columbia, MD
  • NPI 1144291899
  Care Compare affiliation
• Montgomery General Hospital, Inc.

  • General Acute Care Hospital
  • Olney, MD
  • NPI 1114922341
  Care Compare affiliation

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1568061281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321384",
            "telephone_number": "301-774-0500",
            "fax_number": "301-774-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321384",
            "telephone_number": "301-774-0500",
            "fax_number": "301-774-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "SAMANTHA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF PHYSICIANS",
            "identifier": "C0007752",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GASIOR",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Olney, MD
• Providers in Olney, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.