Individual provider Active NPI

Samantha Jo Russin, PA-C

  • Physician Assistant
  • Allentown, PA
National Provider Identifier
1760140529
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063121 Issued in PA
Practice address
1250 S Cedar Crest Blvd
Allentown, PA 18103-6224
Phone
(610) 402-8900
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA063121 PA Primary
Physician Assistant 363A00000X OA005919 PA

Addresses

Primary practice location

1250 S Cedar Crest Blvd
Allentown, PA 18103-6224

Mailing address

59 Railroad St
Glen Lyon, PA 18617-1005
Phone (570) 266-1473

Other practice location 1

1000 Alliance Dr
Hazle Township, PA 18202-3234
Phone (570) 501-6450

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
I20211216001076 PA Practitioner - Physician Assistant 9830580315 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

50 Moisey Dr
Suite 101
Hazle Township, PA 18202-9297
Phone (570) 459-2226

Hospital & facility affiliations

  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185

Merit-based Incentive Payment System (MIPS)

Final score
79.5 of 100Reported as group
Quality
66.14
Promoting interoperability
85
Improvement activities
40
Cost
74.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063121PAMDPhysician Assistant
OA005919PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Partners Community Health Center Current Accepting new patients
Hazleton Professional Services CurrentSince Oct 13, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1627 Chew St
Fl 1
Allentown, PA 18102
Phone (610) 969-2800

400 N 17th St
Ste 300
Allentown, PA 18104
Phone (610) 969-3100

401 N 17th St
Ste 210
Allentown, PA 18104
Phone (610) 821-4920

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

120 Burrus Blvd
Ste 200
Brodheadsville, PA 18322
Phone (570) 420-6300

179 Independence Rd
East Stroudsburg, PA 18301
Phone (570) 421-8526

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

50 Moisey Dr
Ste 208
Hazle Township, PA 18202
Phone (570) 501-6380

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

1000 Alliance Dr
Hazleton, PA 18202
Phone (570) 501-6400

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

171 Red Horse Rd
Pottsville, PA 17901
Phone (570) 628-2229

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

6 S Greenview Rd
Schuylkill Haven, PA 17972
Phone (570) 366-3915

600 Commerce Blvd
Stroudsburg, PA 18360
Phone (570) 424-7390

642 State Route 93 Hwy
Sugarloaf, PA 18249
Phone (570) 708-1505

Organizations & group practices 7

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 1

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1760140529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 RAILROAD ST",
            "city": "GLEN LYON",
            "state": "PA",
            "postal_code": "186171005",
            "telephone_number": "570-266-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036224",
            "telephone_number": "610-402-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Alliance Dr",
            "address_purpose": "LOCATION",
            "city": "Hazle Township",
            "state": "PA",
            "postal_code": "182023234",
            "country_code": "US",
            "telephone_number": "570-501-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSIN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063121",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA005919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.