Individual provider Active NPI

Sam Michael Schuberg, PA-C

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1821853557
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14852 Issued in MN
Practice address
2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone
(651) 968-5201
Fax
(651) 968-5903
NPI assigned
Feb 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14852 MN Primary

Addresses

Primary practice location

2090 Woodwinds Dr
Woodbury, MN 55125-2522

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240308000122 MN Practitioner - Physician Assistant 5496191843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

1661 Saint Anthony Ave
Saint Paul, MN 55104-3733
Phone (651) 968-5201

2090 Woodwinds Dr
Saint Paul, MN 55125-2522
Phone (651) 968-5201

3580 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 968-5201

Hospital & facility affiliations

  • M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics LTD CurrentSince Mar 18, 2024 Accepting new patients
Summit Orthopedics, LTD. CurrentSince Mar 18, 2024 Accepting new patients
Summit Orthopedics LTD Current Accepting new patients

Locations

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5600

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

Interoperability endpoints

  • Direct secure messaging: samschuberg@sol.allscriptsdirect.net

Organizations & group practices 4

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": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1821853557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBERG",
        "first_name": "SAM",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.