Individual provider Active NPI

Samuel Quincy Gaines, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1578039632
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8459 Colerain Ave
Cincinnati, OH 45239-3938
Phone
(513) 815-3851
Fax
(859) 572-2326
NPI assigned
Oct 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8459 Colerain Ave
Cincinnati, OH 45239-3938

Mailing address

8459 Colerain Ave
Cincinnati, OH 45239-3938
Phone (513) 815-3851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH, IL, IN4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20181102002281 KY Practitioner - Physician Assistant 2668725946 Reassigns benefits to 1 organization
I20190614000348 OH Practitioner - Physician Assistant 2668725946 Reassigns benefits to 4 organizations
I20231114001251 IL Practitioner - Physician Assistant 2668725946 Reassigns benefits to 1 organization
I20240321003221 IN Practitioner - Physician Assistant 2668725946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urgent Care Specialists, LLCGroup PAC ID 1850311010, 81 clinicians
Christ Hospital Medical Specialists LLCGroup PAC ID 6507998432, 127 clinicians

Practice addresses (Care Compare)

1068 State Route 28
Milford, OH 45150-2095
Phone (513) 831-5900

11140 Montgomery Rd
Cincinnati, OH 45249-2309
Phone (513) 421-5558

1301 W 1St St
Springfield, OH 45504-1920
Phone (937) 322-6222

2123 Auburn Ave
Cincinnati, OH 45219-2906

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-2323

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, PC CurrentSince Nov 1, 2021 Accepting new patients
Urgent Care Specialists, LLC CurrentSince Jun 1, 2021 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Nov 1, 2021 Accepting new patients
Incare Health Solutions, LLC Physician Assistant CurrentSince Jun 1, 2019 Accepting new patients

Locations

3800 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 203-2051

123 S Franklin Rd
Bloomington, IN 47404
Phone (812) 339-2305

4903 S Emerson Ave
Indianapolis, IN 46203
Phone (317) 352-5582

1010 S Reed Rd
Kokomo, IN 46901
Phone (765) 252-2176

102 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 237-3224

1313 W McGalliard Rd
Muncie, IN 47303
Phone (765) 216-3115

8459 Colerain Ave
Cincinnati, OH 45239
Phone (434) 944-0053

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

6210 Brandt Pike
Ste 102
Huber Heights, OH 45424
Phone (937) 236-8630

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

1301 W 1st St
Springfield, OH 45504
Phone (937) 271-0066

Organizations & group practices 8

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 1

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1578039632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8459 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452393938",
            "telephone_number": "513-815-3851",
            "fax_number": "513-834-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8459 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452393938",
            "telephone_number": "513-815-3851",
            "fax_number": "859-572-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "SAMUEL",
        "middle_name": "QUINCY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.