SAMANTHA N FANOK (PA-C) – Speech/Language/Hearing Specialist/Technologist, NPI 1962040105
Speech/Language/Hearing Specialist/Technologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,578 PHYSICIAN ASSISTANT in NJ
Provider Addresses for SAMANTHA N FANOK (PA-C)
123 BENNETTS MILLS RD
JACKSON, NJ 085274514
Phone: (732) 547-0972
Type: Mailing
2315 ROUTE 34 S
MANASQUAN, NJ 087361444
Phone: (732) 974-0404
Fax: (732) 449-4271
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 48 Open Payments records for all available years, with a total value of $749.
Total Amount is formed as General ($749) + Research ($0) + Ownership ($0) = $749.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Corcept Therapeutics ($171).
Total Amount
$749
General + Research + Ownership
Payments
48
Total payment records
General Amount
$749
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corcept Therapeutics | $171 |
| Lilly USA, LLC | $148 |
| Novo Nordisk Inc | $45 |
| Insulet Corporation | $34 |
| Xeris Pharmaceuticals, Inc. | $34 |
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: 2023-10-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231024001846 | I | Physician Assistant | NJ | TBD |
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.
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 08527)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | NJ | |
| Pain Management, Anesthesiology | NJ | |
| Physical Therapist In Private Practice | NJ | |
| Sports Medicine, Family Practice | NJ | |
| Orthopedic Surgery | NJ | |
| Hand Surgery, Orthopedic Surgery | NJ | |
| Physician Assistant | NJ | |
| Physical Therapist In Private Practice | NJ | |
| Occupational Therapist In Private Practice | NJ | |
| Orthopedic Surgery | PA |
Reviews
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