Samuel Larking Rayburn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2335 Issued in NE

Practice address

2207 Osborne Dr W Ste 100
Hastings, NE 68901-9111

Phone

(402) 462-2139

NPI assigned

Mar 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Mary Lanning Memorial Hospital AssociationGroup PAC ID 4587575550, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srayburn177628@direct.nebraskamed.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.

• The Mary Lanning Memorial Hospital Association

  • Family Medicine Physician
  • Hastings, NE
  • NPI 1356656417
  Medicare reassignment Care Compare group NPD
• The Mary Lanning Memorial Hospital Association

  • Anatomic Pathology & Clinical Pathology Physician
  • Hastings, NE
  • NPI 1760530216
  NPD
• Hastings Family Practice, P.C

  • Family Medicine Physician
  • Hastings, NE
  • NPI 1356383756
  NPD (past)

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

• The Mary Lanning Memorial Hospital Association

  • Clinical Medical Laboratory
  • Hastings, NE
  • NPI 1205442258

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  • Rural Acute Care Hospital
  • Hastings, NE
  • NPI 1831203488
  Care Compare affiliation

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1659830313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 OSBORNE DR W STE 100",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689019111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 OSBORNE DR W STE 100",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689019111",
            "telephone_number": "402-462-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "SAMUEL",
        "middle_name": "LARKING",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Rasher-Miller, LMHP
• Elizabeth D Rasmussen, APRN
• Tyler E Rath
• Jessica L Rathje
• Cassidy Ray
• Recovery of Hope Counseling, LLC
• Kelleen Redinger, B.S.N.
• Redline Pharmacy Solutions LLC
• Redline Pharmacy Solutions, LLC.
• Hilarie Lynn Redline

• Physician Assistant in Hastings, NE
• Providers in Hastings, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.