Individual provider Active NPI

Samantha Rae Neidig, PT, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1972106029
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-012404 Issued in AZ
Practice address
2424 N Wyatt Dr Ste 130
Tucson, AZ 85712-6102
Phone
(520) 784-6570
Fax
(520) 784-6575
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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 LPT-012404 AZ Primary

Addresses

Primary practice location

2424 N Wyatt Dr Ste 130
Tucson, AZ 85712-6102

Mailing address

PO Box 31630
Tucson, AZ 85751-1630
Phone (520) 784-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230307001070 IL Practitioner - Physical Therapist in Private Practice 2264844893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians

Practice addresses (Care Compare)

3030 Frank Scott Pkwy W
Suite 9
Belleville, IL 62223-5014
Phone (618) 235-8565

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Feb 10, 2023 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Feb 10, 2023 Accepting new patients

Locations

3030 Frank Scott Pkwy W
Ste 9
Belleville, IL 62223
Phone (618) 235-8565

144 Lincoln Place Ct
Ste 1
Belleville, IL 62221
Phone (618) 233-5163

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

Organizations & group practices 2

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": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1972106029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31630",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511630",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 N WYATT DR STE 130",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126102",
            "telephone_number": "520-784-6570",
            "fax_number": "520-784-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDIG",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-012404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.