Individual provider Active NPI

Samuel Cantler, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1780165514
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65153 Issued in CA
Practice address
3811 Valley Centre Dr
San Diego, CA 92130-3318
Phone
(858) 764-3028
NPI assigned
Aug 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 C0008522 MD
Physician Assistant 363A00000X 65153 CA Primary

Addresses

Primary practice location

3811 Valley Centre Dr
San Diego, CA 92130-3318

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 764-3028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, CA2 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
I20231106003730 DC Practitioner - Physician Assistant 8224410618 Reassigns benefits to 1 organization
I20250221001152 CA Practitioner - Physician Assistant 8224410618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

3811 Valley Centre Dr
San Diego, CA 92130-3318
Phone (858) 764-3000

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Lorian Health Home health agency, San Diego, CA, CCN 058113
  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65153CAMDDentist
C0008522MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Physician Assistant Current Accepting new patients
Scripps Health CurrentSince Feb 3, 2025 Accepting new patients
Scripps Health CurrentSince Feb 3, 2025 Accepting new patients
Scripps Health Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

3811 Valley Centre Dr
San Diego, CA 92130
Phone (858) 554-8645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

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 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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1780165514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-764-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 VALLEY CENTRE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303318",
            "telephone_number": "858-764-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTLER",
        "first_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008522",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.