SAMANTHA ASHLEY MEDER (PA-C) – Physician Assistant, NPI 1093415705

SAMANTHA ASHLEY MEDER (PA-C) is a healthcare provider. based in Fort pierce, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 9116866 (FL). The NPI Number for SAMANTHA ASHLEY MEDER (PA-C) is 1093415705

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA ASHLEY MEDER (PA-C)
NPI
1093415705
Phone
(772) 461-4000
Address
1700 S 23RD ST
Enumeration Date
9 March 2023
Last Update Date
15 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7724623939
Graduation Year
2022 (4 years ago)
PAC ID
7719349091
Group Practice PAC ID
4789750118
Professional Enrollment ID
I20230818000004
Address ID
FL349504838FO2402XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for SAMANTHA ASHLEY MEDER (PA-C)

  • 1700 S 23RD ST

    FORT PIERCE, FL 349504803

    Phone: (772) 461-4000

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-08-18

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
I20230818000004IPhysician AssistantFLTBD

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 34950)

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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: 4789750118View full group profile
NameSpecialtyState
Critical Care (Intensivists), General SurgeryOK
Physician AssistantTN
General Surgery, Critical Care (Intensivists)FL
General SurgeryFL
Orthopedic SurgeryNM
Critical Care (Intensivists)FL
-FL
-FL
Physician AssistantFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is the standard ID for SAMANTHA ASHLEY MEDER (PA-C) in the U.S.?
In the U.S., SAMANTHA ASHLEY MEDER (PA-C) is identified by NPI 1093415705.
Quick check: is SAMANTHA ASHLEY MEDER (PA-C) active?
Public NPPES data shows SAMANTHA ASHLEY MEDER (PA-C) with an active NPI status right now.
What type of care does SAMANTHA ASHLEY MEDER (PA-C) provide?
SAMANTHA ASHLEY MEDER (PA-C)'s profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to SAMANTHA ASHLEY MEDER (PA-C)?
The directory associates SAMANTHA ASHLEY MEDER (PA-C) with Fort Pierce, Florida. Check all listed addresses for suites or satellite offices.
Who maintains SAMANTHA ASHLEY MEDER (PA-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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