Samantha L Gullett, ATC, LAT, OTC, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4560 Lantana Rd Ste 100
Lake Worth, FL 33463-6998

Phone

(561) 967-4400

Fax

(844) 959-0419

NPI assigned

Jan 6, 2021

Last updated

Sep 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Professionals PA

  • Emergency Medicine Physician
  • Deland, FL
  • NPI 1205880853
  Medicare reassignment NPD
• Palm Beach General Surgery LLC

  • Surgery Physician
  • Loxahatchee, FL
  • NPI 1235326760
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southwest Volusia Healthcare Corporation

  dba AdventHealth Fish Memorial

  • General Acute Care Hospital
  • Orange City, FL
  • NPI 1700978558
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  dba Adventhealth Medical Group

  • Internal Medicine Physician
  • Orange City, FL
  • NPI 1902095078

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1841888773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WILLOW CREEK CV",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503820",
            "telephone_number": "954-830-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 LANTANA RD STE 100",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636998",
            "telephone_number": "561-967-4400",
            "fax_number": "844-959-0419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Village Square Xing",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334104547",
            "country_code": "US",
            "telephone_number": "561-627-8500",
            "fax_number": "844-959-0419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 S Peninsula Dr",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321184422",
            "country_code": "US",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLETT",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "credential": "ATC, LAT, OTC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5559",
            "primary": false
        },
        {
            "code": "246ZX2200X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Orthopedic Assistant",
            "state": "FL",
            "license": "201116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guidewell Sanitas I, LLC
• Guidewell Sanitas I, LLC
• Guidewell Sanitas I, LLC
• Guidewell Sanitas I, LLC
• Jacqueline Guillaume, MD
• Gulnaz Mirza MD PA
• Gregory Raymond Gumberich, DC
• Elizabeth Ann Gunther, D.O.
• Patricia Gurreri
• Kylie Gutierrez

• Physician Assistant in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.

Verify at the official NPI Registry.