Samantha Samaryczew

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.011284 Issued in IL

Practice address

378 White Oak LN
Lake Barrington, IL 60010-6223

Phone

(815) 307-3245

NPI assigned

Jun 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edgebrook Dermatology P.C.Group PAC ID 3476650060, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uw Health Hospital, Rockford, IL, CCN 140228

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Edgebrook Dermatology P.C.

  • Dermatology Physician
  • Rockford, IL
  • NPI 1225184948

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• Swedishamerican Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1760542732
  Care Compare affiliation

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1952087181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 WHITE OAK LN",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600106223",
            "telephone_number": "815-307-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 WHITE OAK LN",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600106223",
            "telephone_number": "815-307-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARYCZEW",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "085.011284",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.011284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L Richter, PA-C
• Stephen Paul Rivard, M.D.
• Timothy J Roth, M.D.
• Rush-Select Holdings, LLC. (RUSH Physical Therapy)
• Manisha Sahay, M.D.
• Jordan Samuels, M.D.
• Margaret Sandford
• Kelly Ann Schaeffer, FNP
• Allison Schmitt, PTA
• Megan Schoenleber, MSN, APRN, FNP-BC

• Physician Assistant in Lake Barrington, IL
• Providers in Lake Barrington, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.