Individual provider Active NPI

Samantha Slabyk

  • Physician Assistant
  • Ithaca, NY
National Provider Identifier
1689478810
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033405 Issued in NY
Practice address
201 Dates Dr Ste 102
Ithaca, NY 14850-1345
Phone
(607) 319-5747
NPI assigned
Apr 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 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 033405 NY Primary

Addresses

Primary practice location

201 Dates Dr Ste 102
Ithaca, NY 14850-1345

Mailing address

3 Sheridan Rd Apt D
Chattanooga, TN 37412-1300
Phone (585) 815-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250613000751 NY Practitioner - Physician Assistant 1658882089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Center at IthacaGroup PAC ID 7214847367, 34 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4443

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033405NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Pathology PLLC Current Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jun 30, 2025 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jun 30, 2025 Accepting new patients
United Health Services Hospitals, Inc. PastSince Apr 6, 2025 Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

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 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": "1743724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1689478810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHERIDAN RD APT D",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374121300",
            "telephone_number": "585-815-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DATES DR STE 102",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501345",
            "telephone_number": "607-319-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLABYK",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.