Samantha Kaltenbach, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.008954RX Issued in OH

Practice address

131 Lewis Ave
Circleville, OH 43113-1209

Phone

(614) 539-1800

Fax

(617) 263-3376

NPI assigned

Apr 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Dumbauld Former name

Medicare fee-for-service enrollment

Enrolled in FL, OH2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.59 of 100Reported as group

Quality

100

Promoting interoperability

91

Improvement activities

40

Cost

72.81

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdumbauld@dermswohio.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatologists of Southwestern Ohio, LLC.

  dba Dermatologists of Southwest Ohio, LLC

  • Dermatology Physician
  • Dayton, OH
  • NPI 1801819883
  Medicare reassignment Care Compare group
• Dermatology Associates of Tallahassee PA

  • Dermatology Physician
  • Tallahassee, FL
  • NPI 1295842672
  Medicare reassignment NPD

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1922629302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746747",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746747",
            "telephone_number": "666-808-5058",
            "fax_number": "374-364-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LEWIS AVE",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131209",
            "telephone_number": "614-539-1800",
            "fax_number": "617-263-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALTENBACH",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008954RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9115222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "DUMBAULD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Floyd M Jones, LSW
• Jennifer May Jones
• Wade Adam Jones
• Anna Jordan, LPN
• Jana M Kaiser
• Shogufa Kamin, PA-C
• Judson Scott Karshner
• Anupreet Kaur, M.D.
• Sukhmit Kaur, M.D.
• Kate Keaton, PTA

• Physician Assistant in Circleville, OH
• Providers in Circleville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.