Active NPI
Samantha Park Amato-Rotkowitz, PA-C
- Physician Assistant
- Philadelphia, PA
National Provider Identifier
1790937217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MD063556L
- Practice address
- 1331 E Wyoming Ave
Philadelphia, PA 19124-3808 - Phone
- (215) 537-7065
- Fax
- (215) 537-7861
- NPI assigned
- Oct 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00207500 | NJ | |
| Physician Assistant | 363A00000X | MD063556L | PA | Primary |
Addresses
Primary practice location
1331 E Wyoming Ave
Philadelphia, PA 19124-3808
Mailing address
1331 E Wyoming Ave
Philadelphia, PA 19124-3808
Phone (215) 537-7065
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MP00207500 | Other | NJ | MEDICAL LICENSE |
| MD063556L | Other | PA | MEDICAL LICENSE |
Other names 1
- Ms. Samantha Park Amato
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101207001154 | PA | Practitioner - Physician Assistant | 4789748583 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1790937217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 E WYOMING AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191243808",
"telephone_number": "215-537-7065",
"fax_number": "215-537-7861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 E WYOMING AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191243808",
"telephone_number": "215-537-7065",
"fax_number": "215-537-7861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMATO-ROTKOWITZ",
"first_name": "SAMANTHA",
"middle_name": "PARK",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-15",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00207500",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MD063556L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "25MP00207500",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MD063556L",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "AMATO",
"middle_name": "PARK",
"prefix": "MS.",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.