Individual provider Active NPI

Samantha Louise Wulf, FNP-BC

  • Family Nurse Practitioner
  • Bentleyville, PA
National Provider Identifier
1710625850
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP025759 Issued in PA
Practice address
309 Russie Ave
Bentleyville, PA 15314-1435
Phone
(724) 884-3848
NPI assigned
May 26, 2022
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP025759 PA Primary

Addresses

Primary practice location

309 Russie Ave
Bentleyville, PA 15314-1435

Mailing address

309 Russie Ave
Bentleyville, PA 15314-1435
Phone (724) 884-3848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20221026000206 PA Practitioner - Nurse Practitioner 2860868270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mon-Vale Primary Care Practices IncGroup PAC ID 4880837772, 9 clinicians

Practice addresses (Care Compare)

447 W Main St
Monongahela, PA 15063-2564
Phone (724) 258-2070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025759PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain and Spine Specialists of Maryland, LLC CurrentSince Jul 15, 2022 Accepting new patients
Mon-Vale Primary Care Practices Inc CurrentSince Dec 9, 2023 Accepting new patients
Mon-Vale Primary Care, Inc. Past Accepting new patients
Monongahela Valley Hospital, Inc. Past Accepting new patients

Locations

2702 Back Acre Cir
Ste 290B
Mount Airy, MD 21771
Phone (301) 760-3317

100 Emerson Ln
Ste 1507
Bridgeville, PA 15017
Phone (412) 506-0334

2614 Memorial Blvd
Ste A
Connellsville, PA 15425
Phone (724) 638-4537

6108 Brownsville Road Ext
Ste 204
Finleyville, PA 15332
Phone (724) 782-0723

1163 Country Club Rd
Monongahela, PA 15063
Phone (724) 258-1000

447 W Main St
Monongahela, PA 15063
Phone (724) 258-2070

800 Plaza Dr
Ste 210
Rostraver Township, PA 15012
Phone (724) 379-1940

800 Plaza Dr
Ste 290
Rostraver Township, PA 15012
Phone (724) 379-6850

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11878/brand/3/csg/1/fhir/r4
  • Direct secure messaging: samantha.wulf.1@11878.direct.athenahealth.com
  • Direct secure messaging: samantha.wulf.2@11878.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1710625850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 RUSSIE AVE",
            "city": "BENTLEYVILLE",
            "state": "PA",
            "postal_code": "153141435",
            "telephone_number": "724-884-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 RUSSIE AVE",
            "city": "BENTLEYVILLE",
            "state": "PA",
            "postal_code": "153141435",
            "telephone_number": "724-884-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULF",
        "first_name": "SAMANTHA",
        "middle_name": "LOUISE",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentleyville, PA

Sources for this page

Verify at the official NPI Registry.