SAMANTHA DORMAN PA
NPI 1417209644
Clinical Nurse Specialist - Psychiatric/Mental Health in Mesa, AZ

Active since October 11, 2012PECOS EnrolledAccepts Medicare Assignment
2204 S DOBSON RD STE 201, MESA, AZ 85202(602) 230-7373(480) 629-8577 Get Directions Write a Review

NPPES record last updated: November 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 17, 2023, Aug 16, 2023, Nov 18, 2021 and 1 more (4 updates tracked since 2018).

About Samantha Dorman Pa NPPES

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

SAMANTHA DORMAN PA (NPI 1417209644) is an individual psychiatric/mental health provider in Mesa, Arizona, licensed in Arizona (5276) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1417209644
Entity TypeIndividualFemale
Primary Taxonomy364SP0808X
Provider Legal NameSAMANTHA DORMANCredential: PA
Location Address2204 S DOBSON RD STE 201Mesa, AZ 85202-6457
Mailing Address3101 N Central Ave Ste 550Phoenix, AZ 85012-2635 · (602) 230-7373 · Fax (602) 230-7373
Fax(480) 629-8577
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 11, 2012
Last NPPES UpdateNovember 17, 20234 updates tracked since enumeration
NPPES CertifiedNovember 17, 2023
NPI 1417209644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0808X
License Licensed in AZ · 5276
Also ListedPhysician AssistantTaxonomy 363A00000X · License 5276 (AZ)
2204 S DOBSON RD STE 201, Mesa, AZ 85202

Other Identifiers 1

Medicaid747718AZ

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

Samantha Dorman 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 ID5890947683
PECOS Enrollment IDI20121221000126
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

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
58 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85202 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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 12

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

Counselor (Mental Health)
2204 S DOBSON RD STE 201
MESA, AZ 85202
Marriage & Family Therapist
2204 S DOBSON RD STE 201
MESA, AZ 85202
Counselor (Professional)
2204 S DOBSON RD STE 201
MESA, AZ 85202
Counselor (Mental Health)
2204 S DOBSON RD STE 201
MESA, AZ 85202
Counselor (Mental Health)
2204 S DOBSON RD STE 201
MESA, AZ 85202
Counselor (Mental Health)
2204 S DOBSON RD STE 201
MESA, AZ 85202
Social Worker
2204 S DOBSON RD STE 201
MESA, AZ 85202
Social Worker
2204 S DOBSON RD STE 201
MESA, AZ 85202

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 Dorman's NPI number?

The NPI number for Samantha Dorman is 1417209644. It was assigned to this individual provider in the NPPES registry on October 11, 2012.

Where is Samantha Dorman located?

Samantha Dorman practices at 2204 S Dobson Rd Ste 201, Mesa, AZ 85202. The listed phone number is (602) 230-7373.

What is Samantha Dorman's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

Is Samantha Dorman enrolled in Medicare?

Yes. Samantha Dorman 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 Dorman accept?

Health plans from Antidote Health Plan of Arizona, Inc. and Blue Cross Blue Shield of Arizona list Samantha Dorman 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.

When was this NPI record last updated?

The NPPES record for Samantha Dorman was last updated on November 17, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.