Samuel Simmons, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1690 Issued in NV

Practice address

1280 E Calvada Blvd
Pahrump, NV 89048-5693

Phone

(775) 751-3377

Fax

(775) 751-2323

NPI assigned

Oct 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, AK2 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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Municipality of SkagwayGroup PAC ID 0244227726, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: sesimmons@direct.y-chc.org
• Direct secure messaging: samuel.simmons.1@15635.direct.athenahealth.com

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.

• Municipality of Skagway

  • Federally Qualified Health Center (FQHC)
  • Skagway, AK
  • NPI 1063574200
  Medicare reassignment Care Compare group NPD
• Metlakatla Indian Community

  • Health Service Clinic/Center
  • Metlakatla, AK
  • NPI 1740294081

  TX

  Medicare reassignment
• Yakutat Tribal Health Board

  • Clinic/Center
  • Yakutat, AK
  • NPI 1871529628

  Physician Assistant

  NPD
• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279
  NPD (past)

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1619305828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 E CALVADA BLVD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485693",
            "telephone_number": "775-751-3377",
            "fax_number": "775-751-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Skagway",
            "state": "AK",
            "postal_code": "998400537",
            "country_code": "US",
            "telephone_number": "907-983-2255",
            "fax_number": "907-983-2793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-25",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1690",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "200272",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1736158",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619305828",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn Leialoha Shope
• Lindiane Shultis
• Janette Sibley, PT
• Amy Lynn Silveira
• Silver State Health Services
• Sheri Simon
• Tammy Simon
• Toni L Sinclair
• Linnea Siniaho, LCSW, CADC-I
• Shannon Sistrunk

• Medical Physician Assistant in Pahrump, NV
• Providers in Pahrump, NV by specialty
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.