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DR. SAMANTHA GWEN BROCK MD
NPI 1104323880
Surgery in Jb Andrews, MD

Active since April 10, 2018PECOS Enrolled
1060 W PERIMETER RD # R, JB ANDREWS, MD 20762(240) 612-2464 Get Directions Write a Review

NPPES record last updated: September 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2024, Nov 21, 2023, May 6, 2018 and 1 more (4 updates tracked since 2018).

About Dr. Samantha Gwen Brock Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMANTHA GWEN BROCK MD (NPI 1104323880) is an individual surgery provider in Jb Andrews, Maryland, licensed in Indiana (01083831A) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1104323880
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDR. SAMANTHA GWEN BROCKCredential: MD
Location Address1060 W PERIMETER RD # RJb Andrews, MD 20762-6602
Mailing Address1060 W Perimeter Rd Rm 3k43Jb Andrews, MD 20762-6602 · (240) 612-2464
Phone(240) 612-2464
Sole ProprietorYes
Enumeration DateApril 10, 2018
Last NPPES UpdateSeptember 5, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2024
✔ NPI 1104323880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IN · 01083831A
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1060 W PERIMETER RD # R, Jb Andrews, MD 20762
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Secondary Practice Locations 3

Location 151ST MDG, Unit 2060, 51st Medical GroupAPO, AP 96278-2060 · Phone (315) 784-0196
Location 24881 Sugar Maple DrWright Patterson AFB, OH 45433-5529 · Phone (937) 257-8715
Location 3128 E. Apple St., WCHE 7th FloorDayton, OH 45409 · Phone (937) 208-4953

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samantha Gwen Brock Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20762 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Brock's NPI number?

The NPI number for Samantha Brock is 1104323880. It was assigned to this individual provider in the NPPES registry on April 10, 2018.

Where is Samantha Brock located?

Samantha Brock practices at 1060 W Perimeter Rd # R, Jb Andrews, MD 20762. The listed phone number is (240) 612-2464.

What is Samantha Brock's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Samantha Brock enrolled in Medicare?

Yes. Samantha Brock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samantha Brock was last updated on September 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.