Individual provider Active NPI

Samantha Payseno, PA

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1679954747
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA52554 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3391
Phone
(559) 256-5200
NPI assigned
Jun 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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 PA52554 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3391

Mailing address

1630 E Herndon Ave
Fresno, CA 93720-3391
Phone (559) 256-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150901001448 CA Practitioner - Physician Assistant 2567778830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1630 E Herndon Ave
Fresno, CA 93720-3391
Phone (559) 290-7051

2335 E Kashian LN
Fresno, CA 93701-2234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA52554CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Pacific Orthopaedic Center Medical Group, Inc. CurrentSince Jul 21, 2015 Accepting new patients
Community Foundation Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Community Foundation Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Fresno Surgery Center LP Past Accepting new patients

Locations

1630 E Herndon Ave
Fresno, CA 93720
Phone (559) 256-5200

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

Interoperability endpoints

  • Direct secure messaging: samantha.payseno.p1@direct.spocortho.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1679954747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203391",
            "telephone_number": "559-256-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203391",
            "telephone_number": "559-256-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYSENO",
        "first_name": "SAMANTHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.