Samantha Rose Jacot, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009921 Issued in CA

Practice address

1941 Johnson Ave Ste 301
San Luis Obispo, CA 93401-4175

Phone

(805) 786-4111

Fax

(805) 543-6357

NPI assigned

Sep 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Rose Libert Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Pacific Central Coast Health Centers

  dba Marian Community Clinic

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  Medicare reassignment Care Compare group NPD
• Pacific Central Coast Health Centers

  dba Dignity Health Perinatal Center - San Luis Obispo

  • Community Health Clinic/Center
  • San Luis Obispo, CA
  • NPI 1689024259
  NPD
• Pacific Central Coast Health Centers

  dba Fair Oaks Specialty Center

  • Community Health Clinic/Center
  • Arroyo Grande, CA
  • NPI 1831764117
  NPD
• Pacific Central Coast Health Centers

  dba Monarch Village Health Center

  • Community Health Clinic/Center
  • Nipomo, CA
  • NPI 1417555061
  NPD (past)
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

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

• Dignity Community Care

  dba French Hospital Medical Center

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1881760452
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1902380884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE STE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014175",
            "telephone_number": "805-786-4111",
            "fax_number": "805-543-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE STE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014175",
            "telephone_number": "805-786-4111",
            "fax_number": "805-543-6357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 S Palisade Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545932",
            "country_code": "US",
            "telephone_number": "805-922-0481",
            "fax_number": "805-925-5261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Fair Oaks Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934203929",
            "country_code": "US",
            "telephone_number": "805-473-0700",
            "fax_number": "805-473-5931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Posada Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934654060",
            "country_code": "US",
            "telephone_number": "805-434-5497",
            "fax_number": "805-434-0917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 S Palisade Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934548903",
            "country_code": "US",
            "telephone_number": "805-354-7101",
            "fax_number": "805-354-7102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOT",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LIBERT",
            "middle_name": "ROSE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jac W. Pedersen II, D.D.S., Inc
• Sarah Jackson
• Ava Blue Jacobsen
• Eric J. Jacobsen, M.D.
• Benjamin Jacobson
• Hashim Saheb Jaderanii, PTA
• Nancy-Ann Keonaona Jambor, M.A., RAS
• James Swift MD Inc (Swift's Critical Care Network for Children Medical Group Inc)
• James W. Lawler, M.D. a Prof Corp
• Daniela James

• Family Nurse Practitioner in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.