Individual provider Active NPI

Samantha L Prochaska, AA

  • Anesthesiologist Assistant
  • Canton, OH
National Provider Identifier
1902465883
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
67.000348 Issued in OH
Practice address
4665 Douglas Cir NW Ste 100
Canton, OH 44718-3673
Phone
(330) 499-5700
Fax
(330) 498-4229
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000348 OH Primary

Addresses

Primary practice location

4665 Douglas Cir NW Ste 100
Canton, OH 44718-3673

Mailing address

4665 Douglas Cir NW Ste 100
Canton, OH 44718-3673
Phone (330) 499-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718003604 OH Practitioner - Anesthesiology Assistant 8921334517 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

158 W Main Rd
Suite 203
Conneaut, OH 44030-2039
Phone (440) 285-2960

3909 Orange PL
Suite 1100
Beachwood, OH 44122-4480
Phone (216) 896-1755

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Anesthesia Group, Inc CurrentSince Jul 15, 2019 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jun 22, 2022 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Jun 22, 2022 Accepting new patients
University Primary Care Practices Inc CurrentSince Jun 22, 2022 Accepting new patients

Locations

3909 Orange Pl
Ste 1100
Beachwood, OH 44122
Phone (216) 896-1755

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

4665 Douglas Cir NW
Ste 100
Canton, OH 44718
Phone (330) 499-5700

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: smitchell33108@ehrdirect.uhhospitals.org

Organizations & group practices 5

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 5

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1902465883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4665 DOUGLAS CIR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183673",
            "telephone_number": "330-499-5700",
            "fax_number": "330-498-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 DOUGLAS CIR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183673",
            "telephone_number": "330-499-5700",
            "fax_number": "330-498-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.