Individual provider Active NPI

Binsey Dawn Sam, PA-C

  • Medical Physician Assistant
  • Lutz, FL
National Provider Identifier
1609489541
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9112708 Issued in FL
Practice address
18560 N Dale Mabry Hwy
Lutz, FL 33548-7900
Phone
(813) 948-7734
Fax
(844) 971-6901
NPI assigned
Aug 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9112708 FL Primary
Acute Care Nurse Practitioner 363LA2100X PA9112708 FL
Family Medicine Physician 207Q00000X PA9112708 FL

Addresses

Primary practice location

18560 N Dale Mabry Hwy
Lutz, FL 33548-7900

Mailing address

9003 Tarawynd CT
Odessa, FL 33556-1724
Phone (321) 614-0149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201230000563 FL Practitioner - Physician Assistant 0345653853 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112708FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifechoices Women'S Care, Inc. Family Medicine CurrentSince Dec 28, 2025 Accepting new patients
Docs Outside the Box Family Medicine PastSince Sep 6, 2020 Accepting new patients

Locations

18560 N Dale Mabry Hwy
Lutz, FL 33548
Phone (813) 948-7734

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1609489541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 TARAWYND CT",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335561724",
            "telephone_number": "321-614-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18560 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487900",
            "telephone_number": "813-948-7734",
            "fax_number": "844-971-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "BINSEY",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9112708",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "PA9112708",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9112708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.