SAMANTHA MAE GLEASON (PA-C) – Physician Assistant, NPI 1790371250

SAMANTHA MAE GLEASON (PA-C) is a healthcare provider. based in Sebastian, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9113781 (FL). The NPI Number for SAMANTHA MAE GLEASON (PA-C) is 1790371250

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA MAE GLEASON (PA-C)
NPI
1790371250
Phone
(722) 202-2265
Address
14110 US HIGHWAY 1
Enumeration Date
17 December 2020
Last Update Date
17 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3217527100
Graduation Year
2020 (6 years ago)
PAC ID
9830504828
Group Practice PAC ID
2466709555
Professional Enrollment ID
I20210225001867
Address ID
FL329358110ME2100XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for SAMANTHA MAE GLEASON (PA-C)

  • 14110 US HIGHWAY 1

    SEBASTIAN, FL 329583233

    Phone: (722) 202-2265

    Type: Location

  • 353 HAWTHORNE LN NE

    PALM BAY, FL 329073259

    Phone: (321) 795-5625

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $221.

Total Amount is formed as General ($221) + Research ($0) + Ownership ($0) = $221.

Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Lilly USA, LLC ($75).

Total Amount

$221

General + Research + Ownership

Payments

11

Total payment records

General Amount

$221

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-08

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: 2021-02-25

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
I20210225001867IPhysician 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 32958)

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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: 2466709555View full group profile
NameSpecialtyState
Internal MedicineOH
Physician AssistantFL

Reviews

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Frequently asked questions

How do I look up SAMANTHA MAE GLEASON (PA-C) by NPI?
Use NPI 1790371250 when you need to reference SAMANTHA MAE GLEASON (PA-C) in forms, claims, or directories.
Does this profile mean SAMANTHA MAE GLEASON (PA-C) is currently active?
Yes — SAMANTHA MAE GLEASON (PA-C) appears active in the national provider directory.
What kind of provider is SAMANTHA MAE GLEASON (PA-C)?
The page reflects Physician Assistant for SAMANTHA MAE GLEASON (PA-C). Clinical services aligned with this taxonomy classification.
Does SAMANTHA MAE GLEASON (PA-C) practice in Florida?
You will see Sebastian, Florida on file for SAMANTHA MAE GLEASON (PA-C) alongside any extra practice locations.
What if Sebastian, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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