DR. SAMUEL JOSEPH PA-C, MD
NPI 1588288203
Physician Assistant in Mount Dora, FL

Q: What is Samuel Joseph's NPI number?

The NPI number for Samuel Joseph is 1588288203. It was assigned to this individual provider in the NPPES registry on May 29, 2020.

Q: What is Samuel Joseph'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 Samuel Joseph was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 29, 2020PECOS EnrolledAccepts Medicare Assignment

4601 N HIGHWAY 19A, MOUNT DORA, FL 32757(352) 602-7924(754) 206-2394 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 6, 2023, Jun 20, 2023, Feb 24, 2023 and 3 more (6 updates tracked since 2020).

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About Dr. Samuel Joseph Pa-c, Md NPPES

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

DR. SAMUEL JOSEPH PA-C, MD (NPI 1588288203) is an individual physician assistant in Mount Dora, Florida, licensed in Arizona (9733) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1588288203

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameDR. SAMUEL JOSEPHCredential: PA-C, MD

Location Address4601 N HIGHWAY 19AMount Dora, FL 32757-2039

Mailing Address22730 Sw 55th AveBoca Raton, FL 33433-6258 · (561) 573-8521

Phone(352) 602-7924

Fax(754) 206-2394

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateMay 29, 2020

Last NPPES UpdateJuly 6, 20236 updates tracked since enumeration

NPPES CertifiedJuly 6, 2023

✔ NPI 1588288203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in AZ · 9733✔ Licensed in FL · TPPA373

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.

Also ListedFamily MedicineTaxonomy 207Q00000X · License HSE32842 (FL)

Also ListedSurgeryTaxonomy 208600000X · License 238000625 (IL)

Also ListedGeneral PracticeTaxonomy 208D00000X · License TPPA373 (PR)

4601 N HIGHWAY 19A, Mount Dora, FL 32757

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Secondary Practice Locations 2

Location 122730 SW 55th AveBoca Raton, FL 33433-6258 · Phone (561) 573-8521

Location 26739 W Cactus RdPeoria, AZ 85381-5311 · Phone (833) 242-0100

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

Dr. Samuel Joseph Pa-c, Md 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 ID9335525435

PECOS Enrollment IDI20230728002549

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 32757 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

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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 5

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

WIDDLER DESHOMMES MD

General Practice