Samantha R. Petillon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1360168 Issued in TX

Practice address

6767 Lake Woodlands Dr Ste F
The Woodlands, TX 77382-2566

Phone

(281) 364-1122

NPI assigned

May 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sterling Ridge Orthopaedics and Sports Medicine LLCGroup PAC ID 8325089055, 43 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.05 of 100Reported as group

Quality

67.43

Promoting interoperability

100

Improvement activities

40

Cost

69.42

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.petillon.1@1066.direct.athenahealth.com

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.

• Sterling Ridge Orthopaedics and Sports Medicine, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • The Woodlands, TX
  • NPI 1881626117
  Medicare reassignment Care Compare group NPD
• Sterling Ridge Orthopaedics and Sports Medicine, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Spring, TX
  • NPI 1154965739
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1811636731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 PALMER HILL DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864783",
            "telephone_number": "832-515-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 LAKE WOODLANDS DR STE F",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822566",
            "telephone_number": "281-364-1122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20639 Kuykendahl Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773793587",
            "country_code": "US",
            "telephone_number": "832-698-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETILLON",
        "first_name": "SAMANTHA",
        "middle_name": "R.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1360168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Peters, LCSW
• Gina Grace Peterson, MSN, APRN, CPNP-AC
• Jason Lee Peterson, PHYSICAL THERAPIST
• Shelly Anne Peterson, LCSW
• Isabella Pethe, APRN-CNP
• Kimberly B Petrie, M.S. CCC-SLP
• Tracy N Petrocelli
• Haley Pettigrew, MS, LMFT, LCDC
• Kelly Christina Petty, SLP
• Tawnya Alayna Pham, OD

• Physical Therapist in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.
• 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.

Verify at the official NPI Registry.