Samuel D. McReynolds, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA60914100 Issued in WA

Practice address

537 Union Ave
Grants Pass, OR 97527-5543

Phone

(541) 479-6777

Fax

(541) 479-6779

NPI assigned

Jun 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smcreynolds987843@wm.providencedirect.org

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.

• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  Medicare reassignment NPD
• Emprise Surgical Associate PLLC

  • Surgical Physician Assistant
  • Scottsdale, AZ
  • NPI 1144364795
  NPD (past) Authorized official
• Centra Health Professional Services, LLC

  • Family Medicine Physician
  • Altavista, VA
  • NPI 1619912441
  NPD
• North Platte Nebraska Physician Group LLC

  • Emergency Medicine Physician
  • North Platte, NE
  • NPI 1740465715
  NPD (past)

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

• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1902832652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 UNION AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275543",
            "telephone_number": "541-479-6777",
            "fax_number": "541-479-6779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7846 E Vista Bonita Dr",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852554123",
            "country_code": "US",
            "telephone_number": "480-860-1045",
            "fax_number": "480-664-8889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "SAMUEL",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60914100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "881062",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nick McNamara, QMHP. CADC II
• Rachel McNamara, LMT
• Sarah Louise McNamara
• Mary McNamee
• Mandy L McNeil
• Joseph McUne, BS
• Molly Meador
• Alysha Marie Meadows, CADCI
• Raymond Edward Meagher, LCSW
• Mec Disabilities

• Surgical Physician Assistant in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.