Active NPI
Amelia Samuelson, PA-C
- Physician Assistant
- Springfield, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.006358RX
- Practice address
- 30 W McCreight Ave Ste 106
Springfield, OH 45504-1853 - Phone
- (937) 523-9820
- Fax
- (937) 523-9829
- NPI assigned
- Aug 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.006358RX | OH | Primary |
Addresses
Primary practice location
30 W McCreight Ave Ste 106
Springfield, OH 45504-1853
Mailing address
30 W McCreight Ave Ste 106
Springfield, OH 45504-1853
Phone (937) 523-9820
Other practice location 1
1000 McKinley Park Dr
Marion, OH 43302-6399
Phone (740) 383-8747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6001 E Broad St
Mount Carmel Palliative Care
Columbus, OH 43213-1502
Phone (614) 234-6000
85 McNaughten Rd
Columbus, OH 43213-5111
Phone (614) 627-2000
Hospital & facility affiliations
- Mount Carmel East & West
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.44 of 100
- Quality
- 75.57
- Promoting interoperability
- 79
- Improvement activities
- 40
- Cost
- 73.41
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.006358RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Carmel Healthproviders Two LLC | Current | Accepting new patients |
Locations
7901 Diley Rd
Ste 140
Canal Winchester, OH 43110
Phone (614) 920-3410
85 McNaughten Rd
Ste 200
Columbus, OH 43213
Phone (614) 759-1186
6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420
6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400
85 McNaughten Rd
Ste 300
Columbus, OH 43213
Phone 61462720006
1945 Newark Granville Rd
Granville, OH 43023
Phone (614) 627-1870
5300 N Meadows Dr
Ste 280
Grove City, OH 43123
Phone (614) 234-8860
4674 Britton Pkwy
Ste 2000
Hilliard, OH 43026
7100 Graphics Way
Ste 2400
Lewis Center, OH 43035
Phone (740) 953-4100
136 E High St
London, OH 43140
Phone (740) 845-0000
477 Cooper Rd
Ste 200
Westerville, OH 43081
Phone (614) 459-7676
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Columbus, OH
- NPI 1134154750
-
- Internal Medicine Physician
- Marion, OH
- NPI 1619230802
-
- Surgery Physician
- Columbus, OH
- NPI 1528203981
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grove City, OH
- NPI 1710067376
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1982784534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1780298570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W MCCREIGHT AVE STE 106",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455041853",
"telephone_number": "937-523-9820",
"fax_number": "937-523-9829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W MCCREIGHT AVE STE 106",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455041853",
"telephone_number": "937-523-9820",
"fax_number": "937-523-9829"
}
],
"practiceLocations": [
{
"address_1": "1000 McKinley Park Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "OH",
"postal_code": "433026399",
"country_code": "US",
"telephone_number": "740-383-8747",
"fax_number": "740-382-6469",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAMUELSON",
"first_name": "AMELIA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-31",
"last_updated": "2022-08-31",
"certification_date": "2022-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.006358RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.