Individual provider Active NPI

Samantha Mei-Ying Fong

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1942768411
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
11808 Grant St FL 100
Omaha, NE 68164-3616
Phone
(877) 230-3885
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

11808 Grant St FL 100
Omaha, NE 68164-3616

Mailing address

11808 Grant St FL 100
Omaha, NE 68164-3616
Phone (877) 230-3885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210910002959 CA Practitioner - Physical Therapist in Private Practice 5890022537 Reassigns benefits to 3 organizations
I20240313001305 NY Practitioner - Physical Therapist in Private Practice 5890022537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043808NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Dec 1, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Feb 1, 2024 Accepting new patients
Sutter Valley Medical Foundation Physical Therapist CurrentSince Dec 1, 2025 Accepting new patients
Precision Physical Therapy & Fitness Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients
California Sports Physical Therapy Centers, Inc. Physical Therapist Current Accepting new patients
Precision Physical Therapy & Fitness Physical Therapist PastSince Jun 12, 2023 Accepting new patients

Locations

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

8030 Soquel Ave
Ste 200
Santa Cruz, CA 95062
Phone (831) 464-8200

269 Mount Hermon Rd
Ste 204
Scotts Valley, CA 95066
Phone (831) 464-8200

250 W Main St
Woodland, CA 95695
Phone (916) 668-6100

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1942768411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 GRANT ST FL 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643616",
            "telephone_number": "877-230-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 GRANT ST FL 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643616",
            "telephone_number": "877-230-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "SAMANTHA",
        "middle_name": "MEI-YING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.