SAMUEL KOBINA DESOUZA JR. PA-C
NPI 1700419181
Physician Assistant - Medical in Mesa, AZ

Q: What is Samuel Desouza's NPI number?

The NPI number for Samuel Desouza is 1700419181. It was assigned to this individual provider in the NPPES registry on February 13, 2020.

Q: What is Samuel Desouza's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Desouza was last updated on November 9, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 13, 2020

82.49/100

CMS Quality Rating

1500 S DOBSON RD STE 202, MESA, AZ 85202(866) 974-2673 Get Directions Write a Review

NPPES record last updated: November 9, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 9, 2020, Feb 13, 2020 (2 updates tracked since 2020).

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About Samuel Kobina Desouza Jr. Pa-c NPPES

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

SAMUEL KOBINA DESOUZA JR. PA-C (NPI 1700419181) is an individual medical provider in Mesa, Arizona and active in the NPI registry since February 2020. He maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1700419181

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameSAMUEL KOBINA DESOUZA JR.Credential: PA-C

Location Address1500 S DOBSON RD STE 202Mesa, AZ 85202-4724

Mailing Address1500 S Dobson Rd Ste 202Mesa, AZ 85202-4724 · (866) 974-2673

Phone(866) 974-2673

Sole ProprietorYes

Enumeration DateFebruary 13, 2020

Last NPPES UpdateNovember 9, 20202 updates tracked since enumeration

NPPES CertifiedNovember 9, 2020

✔ NPI 1700419181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1500 S DOBSON RD STE 202, Mesa, AZ 85202

Open in Google Maps ↗

Secondary Practice Location 1

Location 14120 N 22nd St Unit 2Phoenix, AZ 85016-6114 · Phone (303) 547-5603

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc., Oscar Health Plan, Inc..Insurance ›

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.49/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

73.09

Promoting Interoperability

100

Improvement Activities

Cost

68.54

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.

BROOKE MANSFIELD PA-C

Physician Assistant