SAMANTHA ROTH PA
NPI 1295543262
Physician Assistant in Cottage Grove, MN

Q: What is Samantha Roth's NPI number?

The NPI number for Samantha Roth is 1295543262. It was assigned to this individual provider in the NPPES registry on December 23, 2024.

Q: What is Samantha Roth's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samantha Roth was last updated on March 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since December 23, 2024PECOS EnrolledAccepts Medicare Assignment

8611 W POINT DOUGLAS RD S, COTTAGE GROVE, MN 55016(651) 458-1884 Get Directions Write a Review

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

Record update history: Mar 5, 2026, Dec 23, 2024 (2 updates tracked since 2024).

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About Samantha Roth Pa NPPES

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

SAMANTHA ROTH PA (NPI 1295543262) is an individual physician assistant in Cottage Grove, Minnesota, licensed in Minnesota (15237) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS, is affiliated with Allina United Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1295543262

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSAMANTHA ROTHCredential: PA

Location Address8611 W POINT DOUGLAS RD SCottage Grove, MN 55016-4005

Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000

Phone(651) 458-1884

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateDecember 23, 2024

Last NPPES UpdateMarch 5, 20262 updates tracked since enumeration

NPPES CertifiedMarch 5, 2026

✔ NPI 1295543262 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 MN · 15237

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.

8611 W POINT DOUGLAS RD S, Cottage Grove, MN 55016

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.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

Samantha Roth Pa 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 ID3072034602

PECOS Enrollment IDI20250311002717

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.

Allina United Hospital

Acute Care Hospitals · Saint Paul, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240038

Location333 North Smith AvenueSaint Paul, MN 55102 · Ramsey County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55016 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

MITCHELL SCOTT SEBRANEK PHYSICIAN ASSISTANT

Physician Assistant