SAMANTHA ANN SHAW
NPI 1457900730
Nurse Practitioner - Gerontology in Winter Park, FL

Q: What is Samantha Shaw's NPI number?

The NPI number for Samantha Shaw is 1457900730. It was assigned to this individual provider in the NPPES registry on September 9, 2019.

Q: What is Samantha Shaw's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Shaw was last updated on July 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 09, 2019PECOS EnrolledAccepts Medicare Assignment

1605 W FAIRBANKS AVE, WINTER PARK, FL 32789(407) 845-8356 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Samantha Ann Shaw NPPES

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

SAMANTHA ANN SHAW (NPI 1457900730) is an individual gerontology provider in Winter Park, Florida, licensed in Florida (APRN11003385) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Orlando, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1457900730

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameSAMANTHA ANN SHAW

Location Address1605 W FAIRBANKS AVEWinter Park, FL 32789-4603

Mailing Address1605 W Fairbanks AveWinter Park, FL 32789-4603 · (407) 845-8356

Phone(407) 845-8356

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateSeptember 9, 2019

Last NPPES UpdateJuly 28, 2025

NPPES CertifiedJuly 28, 2025

✔ NPI 1457900730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in FL · APRN11003385

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License 11003385 (FL)

1605 W FAIRBANKS AVE, Winter Park, FL 32789

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Secondary Practice Location 1

Location 1601 E Rollins StOrlando, FL 32803-1248 · Phone (407) 303-6611

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 Ann Shaw 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 ID4587075775

PECOS Enrollment IDI20250731002452

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 32789 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

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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.

MRS. SHAMIM A HASAN PA-C

Physician Assistant