Samantha Grosteffon

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4031115954 Issued in MI

Practice address

1000 Houghton Ave
Saginaw, MI 48602

Phone

(989) 583-6817

NPI assigned

Jun 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Rae Mikita Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Bay Health CentersGroup PAC ID 2466369046, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.grosteffon.1@27771.direct.athenahealth.com

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.

• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1871684761
  Medicare reassignment Care Compare group NPD
• Alpha Minds Services & TMS LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saginaw, MI
  • NPI 1396554143
  Medicare reassignment NPD
• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Integrated Care Midland

  • Federally Qualified Health Center (FQHC)
  • Midland, MI
  • NPI 1609609536
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1740774058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303",
            "telephone_number": "989-583-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48602",
            "telephone_number": "989-583-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSTEFFON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4031115954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "MIKITA",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassidy Groh
• Jared Timothy Groh, MA, CCC-SLP
• Abbie Jo Gross, R.N.
• Amber Marie Gross, RAC
• Justin Dale Gross
• Growing Through Change, PLLC
• Yuching Sun Groya, OTR
• Grozi, Inc
• Braelyn Grubb
• Abigail Lynn Grudzinski

• Psychiatry Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.