NPIMap

Individual provider Active NPI

Samantha L Naidu, PA-C

  • Surgical Physician Assistant
  • Lakewood, CO
National Provider Identifier
1891533642
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0008936 Issued in CO
Practice address
8095 W Evans PL
Lakewood, CO 80227-2431
Phone
(303) 243-1595
Fax
(303) 243-1595
NPI assigned
Jul 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.0008936 CO Primary
Physician Assistant 363A00000X PA.0008936 CO

Addresses

Primary practice location

8095 W Evans PL
Lakewood, CO 80227-2431

Mailing address

8095 W Evans PL
Lakewood, CO 80227-2431
Phone (303) 243-1595

Other practice location 1

11750 W 2nd Pl Ste 255
Lakewood, CO 80228-1726
Phone (720) 638-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241220003957 CO Practitioner - Physician Assistant 1456888924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527

11650 W 2ND PL
Lakewood, CO 80228-1527

11750 W 2ND PL
Lakewood, CO 80228-1726

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015
  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104
  • Longmont United Hospital Hospital, Longmont, CO, CCN 060003

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

11750 W 2nd Pl
Ste 255
Lakewood, CO 80228
Phone (303) 629-5600

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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 11

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": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1891533642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8095 W EVANS PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802272431",
            "telephone_number": "303-243-1595",
            "fax_number": "303-243-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 W EVANS PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802272431",
            "telephone_number": "303-243-1595",
            "fax_number": "303-243-1595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11750 W 2nd Pl Ste 255",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281726",
            "country_code": "US",
            "telephone_number": "720-638-7500",
            "fax_number": "720-321-8041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0008936",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.