Individual provider Active NPI

Samuel George Vokal

  • Physician Assistant
  • Midland, MI
National Provider Identifier
1669051207
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012829 Issued in MI
Practice address
4100 Campus Ridge Dr
Midland, MI 48640-6139
Phone
(989) 839-1795
Fax
(989) 839-1785
NPI assigned
Apr 2, 2021
Reactivated
May 10, 2024
Last updated
Oct 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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 5601012829 MI Primary

Addresses

Primary practice location

4100 Campus Ridge Dr
Midland, MI 48640-6139

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20241206001990 MI Practitioner - Physician Assistant 9638605116 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601012829MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Aug 18, 2025 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Aug 18, 2025 Accepting new patients
Game Changer Pediatric Therapy Services LLC PastSince Apr 1, 2021 Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4100 Campus Ridge Dr
Midland, MI 48640
Phone (989) 839-1386

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761350400000",
    "number": "1669051207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 CAMPUS RIDGE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406139",
            "telephone_number": "989-839-1795",
            "fax_number": "989-839-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOKAL",
        "first_name": "SAMUEL",
        "middle_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "deactivation_date": "2024-04-23",
        "reactivation_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.