SAMANTHA DARE GULLEDGE PA
NPI 1740991504
Physician Assistant in Wilmington, NC

Active since December 12, 2022PECOS EnrolledAccepts Medicare Assignment
1099 MEDICAL CENTER DR, SUITES 100 AND 201, WILMINGTON, NC 28401(910) 251-9994(910) 763-4666 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 4, 2026, Mar 25, 2026, Sep 12, 2025 and 2 more (5 updates tracked since 2022).

About Samantha Dare Gulledge Pa NPPES

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

SAMANTHA DARE GULLEDGE PA (NPI 1740991504) is an individual physician assistant in Wilmington, North Carolina, licensed in North Carolina (0010-12847) and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1740991504
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSAMANTHA DARE GULLEDGECredential: PA
Location Address1099 MEDICAL CENTER DR, SUITES 100 AND 201Wilmington, NC 28401
Mailing AddressPo Box 23329New York, NY 10087-3329
Fax(910) 763-4666
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 12, 2022
Last NPPES UpdateMay 4, 20265 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
NPI 1740991504 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 NC · 0010-12847
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.

1099 MEDICAL CENTER DR, Wilmington, NC 28401

Secondary Practice Locations 2

Location 1308 S Bennett StBurgaw, NC 28425-5048 · Phone (910) 251-9944
Location 2720 Jefferson StWhiteville, NC 28472-3706 · Phone (910) 251-9944

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 Dare Gulledge 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 ID3375916877
PECOS Enrollment IDI20230303000951
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 9

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
372 services46 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
80 services61 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
79 services64 patients
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.
63 services50 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
50 services42 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
49 services46 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28401 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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 11

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

Physician Assistant
1099 MEDICAL CENTER DR
WILMINGTON, NC 28401
Dermatology
1099 MEDICAL CENTER DR
WILMINGTON, NC 28401
Physician Assistant (Medical)
1099 MEDICAL CENTER DR, SUITE 201
WILMINGTON, NC 28401
Clinic/Center (Primary Care)
1099 MEDICAL CENTER DR, SUITE 100-A
WILMINGTON, NC 28401
Dermatology (MOHS-Micrographic Surgery)
1099 MEDICAL CENTER DR
WILMINGTON, NC 28401
Urology
1099 MEDICAL CENTER DR, STE 101
WILMINGTON, NC 28401
Dermatology
1099 MEDICAL CENTER DR
WILMINGTON, NC 28401
Dermatology
1099 MEDICAL CENTER DR
WILMINGTON, NC 28401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740991504, enumerated as an "individual" on December 12, 2022.

The provider is located at 1099 MEDICAL CENTER DR SUITES 100 AND 201 WILMINGTON, NC 28401 and the phone number is (910) 251-9994.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC and. Please consult your insurance carrier or call the provider to verify.