MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) – Physician Assistant, NPI 1114252863

MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) is a healthcare provider. based in Glendale, Arizona. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 4445 (AZ). The NPI Number for MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) is 1114252863

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
MS. SAMANTHA KANTOR LAISURE-POOL (PA-C)
NPI
1114252863
Phone
(623) 233-1300
Address
6320 W UNION HILLS DR STE A100
Enumeration Date
14 October 2009
Last Update Date
20 June 2019

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
4804672145
Graduation Year
2009 (17 years ago)
PAC ID
2860834934
Group Practice PAC ID
1658505011
Professional Enrollment ID
I20240918001248
Address ID
AZ852246236CH1910XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

3,685 PHYSICIAN ASSISTANT in AZ

Provider Addresses for MS. SAMANTHA KANTOR LAISURE-POOL (PA-C)

  • 6320 W UNION HILLS DR STE A100

    GLENDALE, AZ 853081099

    Phone: (623) 233-1300

    Fax: (623) 233-1313

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 51 Open Payments records for all available years, with a total value of $1,087.

Total Amount is formed as General ($1,087) + Research ($0) + Ownership ($0) = $1,087.

Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Astellas Pharma US Inc ($278).

Total Amount

$1,087

General + Research + Ownership

Payments

51

Total payment records

General Amount

$1,087

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240918001248IPhysician AssistantAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 85308)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658505011View full group profile
NameSpecialtyState
Certified Nurse Midwife (Cnm)ME
O B S T E T R I C S/ G Y N E C O L O G YFL
O B S T E T R I C S/ G Y N E C O L O G YAZ
Physician AssistantAZ
Undefined Physician Type (Specify), Obstetrics/Gynecology, Obstetrics/GynecologyTN
O B S T E T R I C S/ G Y N E C O L O G YAZ
O B S T E T R I C S/ G Y N E C O L O G YNH
-AZ
O B S T E T R I C S/ G Y N E C O L O G YAZ
O B S T E T R I C S/ G Y N E C O L O G YAZ

Reviews

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Frequently asked questions

What NPI should I save for MS. SAMANTHA KANTOR LAISURE-POOL (PA-C)?
Save NPI 1114252863 if you need a stable reference for MS. SAMANTHA KANTOR LAISURE-POOL (PA-C).
Is MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) currently active in the NPI registry?
CMS-published data lists MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) as an active registrant.
Does MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for MS. SAMANTHA KANTOR LAISURE-POOL (PA-C). Clinical services aligned with this taxonomy classification.
Where does public data place MS. SAMANTHA KANTOR LAISURE-POOL (PA-C)?
The snapshot lists Glendale, Arizona for MS. SAMANTHA KANTOR LAISURE-POOL (PA-C); download NPPES for the complete set.
Is MS. SAMANTHA KANTOR LAISURE-POOL (PA-C) a real provider?
This page reflects official NPPES data for NPI 1114252863. Always confirm identity and privileges with the practice and licensing boards.

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