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CHERYL SUSAN SAM
NPI 1659163335
Physician Assistant in Jacksonville, FL

Active since May 20, 2025PECOS Enrolled
841 PRUDENTIAL DR, JACKSONVILLE, FL 32207(404) 862-4654 Get Directions Write a Review

NPPES record last updated: May 20, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Cheryl Susan Sam NPPES

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

CHERYL SUSAN SAM (NPI 1659163335) is an individual physician assistant in Jacksonville, Florida, licensed in Georgia (12894) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659163335
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCHERYL SUSAN SAM
Location Address841 PRUDENTIAL DRJacksonville, FL 32207-8329
Mailing Address3110 Wellbrook DrLoganville, GA 30052-4996 · (770) 862-8477
Phone(404) 862-4654
Sole ProprietorNo
Enumeration DateMay 20, 2025
NPPES CertifiedMay 20, 2025
✔ NPI 1659163335 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 GA · 12894
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.
841 PRUDENTIAL DR, Jacksonville, FL 32207
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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)

Cheryl Susan Sam 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 32207 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 20

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

DR. EMMANUEL PENA D.O.
Pediatrics (Child Abuse Pediatrics)
841 PRUDENTIAL DR, SUITE 1130
JACKSONVILLE, FL 32207
Duval County (904) 603-4199
MUHAMMAD TANVEER UL HAQUE
Student in an Organized Health Care Education/Training Program
841 PRUDENTIAL DR, SUITE 1130
JACKSONVILLE, FL 32207
Duval County (904) 244-3140
DILLON OBERLIN SNYDER DO
Pediatrics
841 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 633-4199
KATHERINE MARGARITIS MS, RD, LD/N
Dietitian, Registered
841 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 633-0920
SHERRY R FAHMI SHENODA M.D.
Pediatrics
841 PRUDENTIAL DR, SUITE 1330
JACKSONVILLE, FL 32207
Duval County (904) 383-1712
DR. AMANDA CRUZ-DEWEESE DO
Emergency Medicine (Pediatric Emergency Medicine)
841 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 396-5682
ARENA CHANEY NP
Nurse Practitioner
841 PRUDENTIAL DR, 10TH FLOOR
JACKSONVILLE, FL 32207
Duval County (904) 398-5404
DR. PAMELA L TRAPANE MD
Medical Genetics (Clinical Genetics (M.D.))
841 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 633-0920

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 Cheryl Sam's NPI number?

The NPI number for Cheryl Sam is 1659163335. It was assigned to this individual provider in the NPPES registry on May 20, 2025.

Where is Cheryl Sam located?

Cheryl Sam practices at 841 Prudential Dr, Jacksonville, FL 32207. The listed phone number is (404) 862-4654.

What is Cheryl Sam's specialty?

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

Is Cheryl Sam enrolled in Medicare?

Yes. Cheryl Sam is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Cheryl Sam was last updated on May 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.