NPIMap

Individual provider Active NPI

Samantha Lee Mitchell, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1659815926
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
210 E Gray St Ste 900
Louisville, KY 40202-3905
Phone
(502) 584-7525
Fax
(502) 584-6851
NPI assigned
Dec 6, 2016
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

210 E Gray St Ste 900
Louisville, KY 40202-3905

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other names 1

  • Samantha Lee Roberson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020002408 KY Practitioner - Physician Assistant 1355749193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 893-1270

210 E Gray St
Suite 900
Louisville, KY 40202-3905
Phone (502) 584-7525

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

9880 Angies Way
Suite 300
Louisville, KY 40241-2853
Phone (502) 584-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.9 of 100Reported as group
Quality
85.93
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Feb 15, 2023 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 15, 2023 Accepting new patients
Community Medical Associates, Inc. Physician Assistant Past Accepting new patients

Locations

9880 Angies Way
Ste 300
Louisville, KY 40241
Phone (502) 629-2225

4123 Dutchmans Ln
Ste 401
Louisville, KY 40207
Phone (502) 394-6341

210 E Gray St
Ste 701
Louisville, KY 40202
Phone (502) 562-6021

9300 Stonestreet Rd
Ste 200
Louisville, KY 40272
Phone (502) 935-8061

9300 Stonestreet Rd
Ste 400
Louisville, KY 40272
Phone (502) 935-8061

4123 Dutchmans Ln
Ste 102
Louisville, KY 40207
Phone (502) 559-1670

4123 Dutchmans Ln
Ste 101
Louisville, KY 40207
Phone (502) 559-1777

210 E Gray St
Ste 900
Louisville, KY 40202
Phone (502) 584-8002

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

3991 Dutchmans Ln
Ste 401
Louisville, KY 40207
Phone (502) 259-3220

3991 Dutchmans Ln
Saint Matthews, KY 40207
Phone (502) 895-6180

150 Frankfort Rd
Ste 102B
Shelbyville, KY 40065
Phone (502) 633-9030

Interoperability endpoints

  • Direct secure messaging: smitchell254628@direct.nortonhealthcare.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1659815926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST STE 900",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023905",
            "telephone_number": "502-584-7525",
            "fax_number": "502-584-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-06",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ROBERSON",
            "middle_name": "LEE",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.