Individual provider Active NPI

Samantha Martin, PA-C

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1750162129
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0011969 Issued in DE
Practice address
4755 Ogletown Stanton Rd Ste 1E50
Newark, DE 19718-2200
Phone
(302) 733-1980
Fax
(302) 733-1986
NPI assigned
Oct 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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 C5-0011969 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Ste 1E50
Newark, DE 19718-2200

Mailing address

1272 Poplar St
East Earl, PA 17519-9462
Phone (171) 768-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231031002036 DE Practitioner - Physician Assistant 5395191191 Reassigns benefits to 1 organization
I20260522000011 PA Practitioner - Physician Assistant 5395191191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians
Lancaster General HospitalGroup PAC ID 1254240039, 520 clinicians

Practice addresses (Care Compare)

1401 Foulk Rd
Wilmington, DE 19803-2764

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

540 N Duke St
110 Penn Medicine LGHP Cardiothoracic Surge
Lancaster, PA 17602-2374
Phone (717) 544-4995

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc CurrentSince Oct 17, 2023 Accepting new patients
Christiana Care Health Services Inc CurrentSince Oct 17, 2023 Accepting new patients

Locations

4755 Ogletown Stanton Rd
#1E50
Newark, DE 19718
Phone (302) 733-1980

4755 Ogletown Stanton Rd
Ste 1E50
Newark, DE 19718
Phone (302) 733-1980

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

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 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": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1750162129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 POPLAR ST",
            "city": "EAST EARL",
            "state": "PA",
            "postal_code": "175199462",
            "telephone_number": "171-768-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 1E50",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1980",
            "fax_number": "302-733-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.