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SAMANTHA MARCOLY
NPI 1275257594
Physician Assistant in Marina Del Rey, CA

Active since September 29, 2022PECOS Enrolled
4650 LINCOLN BLVD, MARINA DEL REY, CA 90292(310) 448-5200 Get Directions Write a Review

NPPES record last updated: December 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 14, 2023, Sep 29, 2022 (2 updates tracked since 2022).

About Samantha Marcoly NPPES

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

SAMANTHA MARCOLY (NPI 1275257594) is an individual physician assistant in Marina Del Rey, California, licensed in California (PA63751) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275257594
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSAMANTHA MARCOLY
Location Address4650 LINCOLN BLVDMarina Del Rey, CA 90292-6306
Mailing Address4650 Lincoln BlvdMarina Del Rey, CA 90292-6306
Phone(310) 448-5200
Sole ProprietorYes
Enumeration DateSeptember 29, 2022
Last NPPES UpdateDecember 14, 20232 updates tracked since enumeration
NPPES CertifiedDecember 14, 2023
✔ NPI 1275257594 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 CA · PA63751
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.
4650 LINCOLN BLVD, Marina Del Rey, CA 90292
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Marcoly 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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
29 services29 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
25 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90292 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

CHASE KRIVASHEI PA
Physician Assistant
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (310) 823-8911
GENERATION MEDICAL SERVICES, A MED CORP
Emergency Medicine
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (469) 401-2386
DR. MANVIR SINGH DHILLON MD
Internal Medicine
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (310) 823-8911
MRS. RESHMA RANGWANI LAKHANI L.C.S.W.
Social Worker (Clinical)
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (310) 760-1777
SUSAN KOHLER MSCCCSLP
Speech-Language Pathologist
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (310) 285-8110
PETREL EMERGENCY PHYSICIANS, A MEDICAL CORPORATION
Emergency Medicine
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (469) 401-2386
MICHELLE RENEE ITKONEN MD
Anesthesiology
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (310) 823-8911
JAMES F KEEFE M D INC
Pathology (Anatomic Pathology & Clinical Pathology)
4650 LINCOLN BLVD
MARINA DEL REY, CA 90292
Los Angeles County (310) 823-8911

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 Marcoly's NPI number?

The NPI number for Samantha Marcoly is 1275257594. It was assigned to this individual provider in the NPPES registry on September 29, 2022.

Where is Samantha Marcoly located?

Samantha Marcoly practices at 4650 Lincoln Blvd, Marina Del Rey, CA 90292. The listed phone number is (310) 448-5200.

What is Samantha Marcoly's specialty?

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

Is Samantha Marcoly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samantha Marcoly was last updated on December 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.