Individual provider Active NPI

Samantha Tuttamore, PA-C

  • Surgical Physician Assistant
  • Washington, DC
National Provider Identifier
1700927365
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA030322 Issued in DC
Practice address
110 Irving St NW
Washington, DC 20010
Phone
(202) 877-5580
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA030322 DC Primary
Surgical Physician Assistant 363AS0400X C0002757 MD

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010

Mailing address

9323 Cedar LN
Bethesda, MD 20814-3974
Phone (773) 220-7268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20050706000240 DC Practitioner - Physician Assistant 2860438488 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone (301) 754-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services of Holy Cross CurrentSince Jun 15, 2012 Accepting new patients
Professional Services of Holy Cross CurrentSince Jun 15, 2012 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Mar 1, 2014 Accepting new patients
Washington Hospital Center Corp CurrentSince Feb 17, 2004 Accepting new patients
Washington Hospital Center Corp CurrentSince Feb 17, 2004 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Mar 1, 2014 Accepting new patients
Suburban Physician Assistant Associates, LLC. Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Interoperability endpoints

  • Direct secure messaging: stuttamore1142656@direct.trinity-health.org

Organizations & group practices 8

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 4

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1700927365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9323 CEDAR LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143974",
            "telephone_number": "773-220-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-877-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTAMORE",
        "first_name": "SAMANTHA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DC",
            "license": "PA030322",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0002757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.