Individual provider Active NPI

Samantha Jean Filipovich, CRNA, DNP

  • Certified Registered Nurse Anesthetist
  • Twentynine Palms, CA
National Provider Identifier
1649854431
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6663 Issued in NC
Practice address
1145 Sturgis Road
Twentynine Palms, CA 92278-8275
Phone
(760) 830-2117
NPI assigned
May 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 6663 NC Primary

Addresses

Primary practice location

1145 Sturgis Road
Twentynine Palms, CA 92278-8275

Mailing address

1145 Sturgis Rd
Twentynine Palms, CA 92278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220126003028 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264824135 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

250 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 535-8240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6663NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Health - Heritage Inc CurrentSince Jan 3, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 17, 2023 Accepting new patients
Onslow Memorial Hospital, Inc. Anesthesiology CurrentSince Feb 5, 2024 Accepting new patients
East Carolina Health - Heritage Inc Anesthesiology CurrentSince Jan 3, 2024 Accepting new patients
Onslow Memorial Hospital Inc CurrentSince Feb 5, 2024 Accepting new patients
East Carolina Health Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 17, 2023 Accepting new patients
East Carolina Health CurrentSince Apr 1, 2023 Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Feb 15, 2022 Accepting new patients

Locations

500 Academy St S
Ahoskie, NC 27910
Phone (252) 209-3000

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700

Organizations & group practices 9

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": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1649854431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 STURGIS RD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 STURGIS ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788275",
            "telephone_number": "760-830-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILIPOVICH",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "credential": "CRNA, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-08",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twentynine Palms, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.