Samantha L Shaw

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.009914RX Issued in OH

Practice address

393 Vinewood Ave
Tallmadge, OH 44278-1350

Phone

(330) 515-6403

NPI assigned

May 9, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Accepts the Medicare-approved amount as payment in full

Group practices

Santibanez Pac Ohio IncGroup PAC ID 7416391545, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Santibanez Pac Ohio Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Rittman, OH
  • NPI 1245005842
  Medicare reassignment Care Compare group
• Pavilion Infusion Therapy Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1073008504
  NPD (past)

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

{
    "created_epoch": "1746748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1881484004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 VINEWOOD AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781350",
            "telephone_number": "330-515-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 VINEWOOD AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781350",
            "telephone_number": "330-515-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-09",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009914RX",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Randall Sellers, M.D.
• Carri Sensius, LPCC-S, NCC
• Patrick J Shaffer, DDS
• Sydney Marie Shahan
• Sandra D. Shavers, HEALTH CARE PROVIDER
• Shelter Care, Inc.
• Lawan Short
• Maxwell Shu
• Rodney F Siddall, DDS
• Sidney Roth, O.D. Inc.

• Physician Assistant in Tallmadge, OH
• Providers in Tallmadge, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.