Individual provider Active NPI

Samantha Abbade, NP

  • Family Nurse Practitioner
  • Weimar, CA
National Provider Identifier
1710446133
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010923 Issued in CA
Practice address
20601 West Paoli Lane
Weimar, CA 95736
Phone
(530) 296-4417
NPI assigned
Mar 15, 2019
Last updated
Mar 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R194825 MD
Family Nurse Practitioner 363LF0000X 95010923 CA Primary

Addresses

Primary practice location

20601 West Paoli Lane
Weimar, CA 95736

Mailing address

501 Fair Meadows Blvd
Hagerstown, MD 21740-6780

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
I20200302001311 CA Practitioner - Nurse Practitioner 6709213861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newstart Medical Group IncGroup PAC ID 8628299799, 22 clinicians

Practice addresses (Care Compare)

20601 W Paoli LN
Weimar, CA 95736-0486
Phone (530) 637-4025

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010923CAMDFamily Nurse Practitioner
R194825MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newstart Medical Group Inc CurrentSince Jan 25, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: samantha.abbade.1@11511.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1710446133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FAIR MEADOWS BLVD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20601 WEST PAOLI LANE",
            "city": "WEIMAR",
            "state": "CA",
            "postal_code": "95736",
            "telephone_number": "530-296-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBADE",
        "first_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R194825",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weimar, CA

Sources for this page

Verify at the official NPI Registry.