DR. SAMANTHA GRACE HATHAWAY DO
NPI 1164166708
Family Medicine in Johnson City, NY

Active since April 20, 2022PECOS EnrolledAccepts Medicare Assignment
515 REYNOLDS RD, JOHNSON CITY, NY 13790(607) 798-5510 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Samantha Grace Hathaway Do NPPES

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

DR. SAMANTHA GRACE HATHAWAY DO (NPI 1164166708) is an individual family medicine provider in Johnson City, New York, licensed in New York (338813) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1164166708
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SAMANTHA GRACE HATHAWAYCredential: DO
Location Address515 REYNOLDS RDJohnson City, NY 13790-1311
Mailing Address104 Springer RdBinghamton, NY 13904-3404 · (845) 820-1864
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 20, 2022
Last NPPES UpdateJuly 24, 2025
NPPES CertifiedJuly 24, 2025
NPI 1164166708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NY · 338813
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
515 REYNOLDS RD, Johnson City, NY 13790

Other Names 1

Former Name (1)Samantha Grace Michalek

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Samantha Grace Hathaway Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901307677
PECOS Enrollment IDI20250903001339
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Our Lady Of Lourdes Memorial Hospital, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330011
Location169 Riverside DriveBinghamton, NY 13905 · Broome County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13790 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
515 REYNOLDS RD
JOHNSON CITY, NY 13790
Dietitian, Registered
515 REYNOLDS RD
JOHNSON CITY, NY 13790

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 Hathaway's NPI number?

The NPI number for Samantha Hathaway is 1164166708. It was assigned to this individual provider in the NPPES registry on April 20, 2022. The provider is also known as Samantha Grace Michalek.

Where is Samantha Hathaway located?

Samantha Hathaway practices at 515 Reynolds Rd, Johnson City, NY 13790. The listed phone number is (607) 798-5510.

What is Samantha Hathaway's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Samantha Hathaway enrolled in Medicare?

Yes. Samantha Hathaway is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samantha Hathaway accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Samantha Hathaway as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samantha Hathaway affiliated with any hospitals?

According to CMS data, Samantha Hathaway is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Samantha Hathaway was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.