Individual provider Active NPI

Samantha A Craner, PA-C, RT(R)

  • Physician Assistant
  • Utica, NY
National Provider Identifier
1881346062
Registry record updated Sep 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030134 Issued in NY
Practice address
1656 Champlin Ave
Utica, NY 13502-4830
Phone
(315) 624-6293
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 863634 NY
Physician Assistant 363A00000X 030134 NY Primary

Addresses

Primary practice location

1656 Champlin Ave
Utica, NY 13502-4830

Mailing address

1656 Champlin Ave
Utica, NY 13502-4830
Phone (315) 624-6293

Other names 1

  • Samantha Grard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230824003025 NY Practitioner - Physician Assistant 6800259797 Reassigns benefits to 3 organizations

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
Crouse Radiology Associates LLPGroup PAC ID 1850387648, 105 clinicians
Medical Imaging Center LLPGroup PAC ID 7911991831, 38 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

37 W Garden St
Suite 107
Auburn, NY 13021-2663
Phone (315) 255-2828

739 Irving Ave
Suite 150
Syracuse, NY 13210-1651
Phone (315) 470-2985

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
75.32
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
863634NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Sep 1, 2023 Accepting new patients
MVHS Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

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 2

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1881346062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-624-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-624-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANER",
        "first_name": "SAMANTHA",
        "middle_name": "A",
        "credential": "PA-C, RT(R)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "863634",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GRARD",
            "credential": "RT(R)",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.