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DISNEY KULACHATI SAMUTSAKORN PA-C
NPI 1255875571
Physician Assistant in Fort Bragg, NC

Active since December 05, 2016PECOS EnrolledAccepts Medicare Assignment
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310(910) 907-8922(910) 907-6069 Get Directions Write a Review

NPPES record last updated: June 11, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 17, 2025, Apr 1, 2025, Oct 23, 2023 and 1 more (4 updates tracked since 2020).

About Disney Kulachati Samutsakorn Pa-c NPPES

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

DISNEY KULACHATI SAMUTSAKORN PA-C (NPI 1255875571) is an individual physician assistant in Fort Bragg, North Carolina, licensed in North Carolina (1138817) and active in the NPI registry since December 2016. He is enrolled in Medicare PECOS, is affiliated with Cape Fear Valley Medical Center, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1255875571
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDISNEY KULACHATI SAMUTSAKORNCredential: PA-C
Location Address2817 ROCK MERRITT AVEFort Bragg, NC 28310-4504
Mailing Address2817 Rock Merritt AveFort Bragg, NC 28310-0001 · (910) 907-8922 · Fax (910) 907-6069
Phone(910) 907-8922
Fax(910) 907-6069
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateDecember 5, 2016
Last NPPES UpdateJune 11, 20264 updates tracked since enumeration
NPPES CertifiedJune 11, 2026
✔ NPI 1255875571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 1138817
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2817 ROCK MERRITT AVE, Fort Bragg, NC 28310
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Plan of North Carolina, Inc, Oscar Insurance Company.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

Disney Kulachati Samutsakorn Pa-c 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 ID6507234283
PECOS Enrollment IDI20250107003566
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 2

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

Cape Fear Valley Medical Center

Acute Care Hospitals · Fayetteville, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340028
Location1638 Owen Drive P O Box 2000Fayetteville, NC 28302 · Cumberland County
Emergency services Birthing friendly

Columbus Regional Healthcare System

Acute Care Hospitals · Whiteville, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340068
Location500 Jefferson StWhiteville, NC 28472 · Columbus County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28310 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

Other Providers at the Same Location NPPES 20

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

JOSEPH CLAIR
Nurse Anesthetist, Certified Registered
2817 ROCK MERRITT AVE, WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC 28310
Cumberland County (910) 907-8922
CASEY TURNER PT, DPT
Physical Therapist
2817 ROCK MERRITT AVE, WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC 28310
Cumberland County (910) 907-6069
DR. ROBERT JOSEPH ROLLER JR. PT, PHD, DPT, ATC
Physical Therapist (Sports)
2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310
Cumberland County (910) 907-8922
ERIN FOLEY PT, DPT
Physical Therapist
2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310
Cumberland County (910) 907-8709
MICHAEL ANDREW SLACK DPT
Physical Therapist
2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310
Cumberland County (224) 715-1689
MRS. COLLEEN MARGARET REMINSKY LAT, ATC
Specialist/Technologist (Athletic Trainer)
2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310
Cumberland County (910) 908-9663
ROBERT AUSTIN JONES PA-C
Physician Assistant
2817 ROCK MERRITT AVE
FORT LIBERTY, NC 28310
Cumberland County (910) 907-8922
BONNIE CLAIRE-KAMEI BARKLEY PA-S
Physician Assistant
2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310
Cumberland County (910) 907-8922

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 Disney Samutsakorn's NPI number?

The NPI number for Disney Samutsakorn is 1255875571. It was assigned to this individual provider in the NPPES registry on December 5, 2016.

Where is Disney Samutsakorn located?

Disney Samutsakorn practices at 2817 Rock Merritt Ave, Fort Bragg, NC 28310. The listed phone number is (910) 907-8922.

What is Disney Samutsakorn's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Disney Samutsakorn enrolled in Medicare?

Yes. Disney Samutsakorn 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 Disney Samutsakorn accept?

Health plans from Oscar Health Plan of North Carolina, Inc and Oscar Insurance Company list Disney Samutsakorn 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 Disney Samutsakorn affiliated with any hospitals?

According to CMS data, Disney Samutsakorn is affiliated with Cape Fear Valley Medical Center and Columbus Regional Healthcare System.

When was this NPI record last updated?

The NPPES record for Disney Samutsakorn was last updated on June 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.