Samantha Nichols, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08988 Issued in TX

Practice address

9000 Rockville Pike BLDG 10
Bethesda, MD 20892-4009

Phone

(240) 858-3219

NPI assigned

Apr 11, 2014

Last updated

Aug 4, 2020By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1982023412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 ROCKVILLE PIKE BLDG 10",
            "address_2": "RM 12-C-101",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "250-858-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 ROCKVILLE PIKE BLDG 10",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208924009",
            "telephone_number": "240-858-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-11",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338140201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xuanthy Nguyen
• Ali Niak, MD
• Kevin Nicastro, LMSW
• Anne-Sarah Nichitiu
• Tasha-Mae Nickesha Nicholas, LCSW
• John Kirkwood Nicholson
• Matthew Ryan Nickles, DO
• Honorato Fenol Nicodemus, MD
• Wasihun Berhe Nicodimos, PHARMD, BCPS, BCMTMS
• Nicola Sater MD LLC

• Physician Assistant in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.