Samantha J Otis (NPI# 1073081824, PAC ID# 5698010692) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1073081824 |
| PAC ID by PECOS | 5698010692 |
| Professional Enrollment ID | I20181219002837 |
| Full Name | Samantha J Otis |
| Organization Legal Name | ST JOSEPHS MEDICAL PC |
| Address |
5100 W Taft Rd Liverpool NY 13088-3807 |
| Phone Number | 3154522828 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4688855844 |
| Number of Group Practice Members | 340 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330140 | ST JOSEPH'S HOSPITAL HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 5100 W Taft Rd, Liverpool, NY 13088-3807 | 3154522828 | ST JOSEPHS MEDICAL PC |
| 5100 W Taft Rd, Liverpool, NY 13088-4841 | ST JOSEPHS MEDICAL PC |
| Organization Legal Name | ST JOSEPHS MEDICAL PC |
| Physicians | 316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley E Crumb | Nurse Practitioner | St Josephs Medical PC | 8278 Willett Pkwy, Fl 2, Baldwinsville, NY 13027-1311 |
| Megan M Wolfe | Nurse Practitioner | St Josephs Medical PC | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3808 |
| Brandon W Crandall | Nurse Practitioner | St Josephs Medical PC | 4103 Medical Ctr Dr, Fayetteville, NY 13066-6600 |
| Kyle Tucci | Nurse Practitioner | St Josephs Medical PC | 4507 Medical Ctr Dr, Fayetteville, NY 13066-6604 |
| Hooman Ranjbaran Jahromi | Cardiovascular Disease (cardiology) | St Josephs Medical PC | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2806 |
| Robert M Kellman | Otolaryngology | St Josephs Medical PC | 4100 Medical Ctr Dr, Suite 117, Fayetteville, NY 13066 |
| Tucker Harris | Otolaryngology | St Josephs Medical PC | 4117 Medical Ctr Dr, Fayetteville, NY 13066-6600 |
| Michael P Gabris | Cardiovascular Disease (cardiology) | St Josephs Medical PC | 1000 E Genesee St, Suite 300, Syracuse, NY 13210-1853 |
| Dennis J Nave | Family Medicine | St Josephs Medical PC | 5586 Legionnaire Dr, Suite 1, Cicero, NY 13039-3504 |
| John P O'brien | Family Medicine | St Josephs Medical PC | 4104 Medical Ctr Dr, Suite 104, Fayetteville, NY 13066-6635 |
| Street Address |
5100 W TAFT RD |
| City | LIVERPOOL |
| State | NY |
| Zip | 13088-3807 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan M Wolfe | Nurse Practitioner | St Josephs Medical PC | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3808 |
| Aaron G Jannetti | Physician Assistant | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-4841 |
| Leslie D Woodcock Jr. | Ophthalmology | Leslie D. Woodcock, Jr., M.d., Pllc | 5100 W Taft Rd, Suite 3l, Liverpool, NY 13088-3809 |
| Anthony Vigliotti | Hospice/palliative Care | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-3807 |
| Douglas M Fetterman | Anesthesiology | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-3807 |
| Dianne M Vitkus | Physician Assistant | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-3807 |
| Robert J Weiss | General Surgery | 5100 W Taft Rd, Suite 2r, Liverpool, NY 13088-4841 | |
| David W Wormuth | Thoracic Surgery | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-3807 |
| Kimberly S Trent | Physician Assistant | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-3807 |
| Muhammad M Abdel Migeed | Cardiac Electrophysiology | St Josephs Medical PC | 5100 W Taft Rd, Liverpool, NY 13088-3807 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly M Finn | Nurse Practitioner | Familycare Medical Group PC | 4820 W Taft Rd, Suite 108, Liverpool, NY 13088-2800 |
| Deborah J Freeman | Nurse Practitioner | Familycare Medical Group PC | 4820 W Taft Rd, Suite 108, Liverpool, NY 13088-2800 |
| Frederick M Farrar | Diagnostic Radiology | Cny Diagnostic Imaging Assoc | 4820 W Taft Rd, Suite 114, Liverpool, NY 13088-2805 |
| Hooman Ranjbaran Jahromi | Cardiovascular Disease (cardiology) | St Josephs Medical PC | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2806 |
| Nelly Y Kazzaz | Cardiovascular Disease (cardiology) | St Josephs Medical PC | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2806 |
| Ayman S Iskander | Cardiovascular Disease (cardiology) | St Josephs Medical PC | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2806 |
| Tina Winter | Nurse Practitioner | St Josephs Medical PC | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2806 |
| Ross W Trent | Physician Assistant | S J H Cardiac Catheterization Associates PC | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2806 |
| Abraham M Masara | Nurse Practitioner | 4756 Summerhurst Dr, Liverpool, NY 13088-3622 | |
| Robert A Dracker | Pediatric Medicine | 4811 Buckley Rd, Liverpool, NY 13088-3629 | |
| Find all physicians in zip 13088 | |||
| City | LIVERPOOL |
| Zip Code | 13088 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LIVERPOOL + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Samantha J Otis.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.