Samantha Missal

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT030374 Issued in PA

Practice address

182 Butler St
Wilkes Barre, PA 18702-4465

Phone

(570) 970-0402

NPI assigned

Apr 13, 2016

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

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Elite Spine and Sports Physical Therapy LP

  • Physical Therapist
  • Wilkes Barre, PA
  • NPI 1932810819
  Medicare reassignment NPD

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1912361197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 BUTLER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187024465",
            "telephone_number": "157-097-0040",
            "fax_number": "570-970-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 BUTLER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187024465",
            "telephone_number": "570-970-0402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Garfield St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "PA",
            "postal_code": "186129090",
            "country_code": "US",
            "telephone_number": "570-606-5933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISSAL",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thais Prata Miranda
• Lucinda Stephanie Mirra, DO
• Wasique Mirza, MD
• Mark F Miscavage, DMD
• Barbara Kelly Missal, BCNP RPH
• Kathryn Corgan Mitchell, PA-C
• Scott Daniel Mitsko
• Kimberly Mary Moffat, MD
• Mohammed Mohiuddin, M.D.
• Naveed Mohsin

• Physical Therapist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.