GRACIE-ANN SAMADH ROBERTS PHYSICIAN ASSISTANT - NPI 1407045917 - Physician Assistant in Staten Island, NY

Q: What is Gracie-ann Roberts's NPI number?

The NPI number for Gracie-ann Roberts is 1407045917. It was assigned to this individual provider in the NPPES registry on October 20, 2007.

Q: What is Gracie-ann Roberts's specialty?

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

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About Gracie-ann Samadh Roberts Physician Assistant NPPES

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

GRACIE-ANN SAMADH ROBERTS PHYSICIAN ASSISTANT (NPI 1407045917) is an individual physician assistant in Staten Island, New York, licensed in New York (011794) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407045917

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameGRACIE-ANN SAMADH ROBERTSCredential: PHYSICIAN ASSISTANT

Location Address439 PORT RICHMOND AVEStaten Island, NY 10302-1714

Mailing Address439 Port Richmond AveStaten Island, NY 10302-1714 · (917) 830-1235

Phone(917) 830-1235

Sole ProprietorNo

Enumeration DateOctober 20, 2007

Last NPPES UpdateJune 4, 20262 updates tracked since enumeration

NPPES CertifiedJune 4, 2026

✔ NPI 1407045917 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 NY · 011794

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.

439 PORT RICHMOND AVE, Staten Island, NY 10302

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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)

Gracie-ann Samadh Roberts Physician Assistant 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 10302 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

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.