SAMANTHA L GULLETT ATC, LAT, OTC, PA-C
NPI 1841888773
Physician Assistant in Lake Worth, FL

Q: What is Samantha Gullett's NPI number?

The NPI number for Samantha Gullett is 1841888773. It was assigned to this individual provider in the NPPES registry on January 6, 2021.

Q: What is Samantha Gullett'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 Samantha Gullett was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since January 06, 2021PECOS Enrolled

4560 LANTANA RD STE 100, LAKE WORTH, FL 33463(561) 967-4400(844) 959-0419 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 10, 2021, Jan 8, 2021 (2 updates tracked since 2021).

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About Samantha L Gullett Atc, Lat, Otc, Pa-c NPPES

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

SAMANTHA L GULLETT ATC, LAT, OTC, PA-C (NPI 1841888773) is an individual physician assistant in Lake Worth, Florida and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS, is affiliated with Adventhealth Fish Memorial, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1841888773

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSAMANTHA L GULLETTCredential: ATC, LAT, OTC, PA-C

Location Address4560 LANTANA RD STE 100Lake Worth, FL 33463-6998

Mailing Address160 Willow Creek CvLongwood, FL 32750-3820 · (954) 830-2776

Phone(561) 967-4400

Fax(844) 959-0419

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJanuary 6, 2021

Last NPPES UpdateSeptember 23, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2025

✔ NPI 1841888773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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 ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License AL5559 (FL)

Also ListedSpecialist/Technologist, Other · Orthopedic AssistantTaxonomy 246ZX2200X · License 201116 (FL)

4560 LANTANA RD STE 100, Lake Worth, FL 33463

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Secondary Practice Locations 2

Location 1222 S Peninsula DrDaytona Beach, FL 32118-4422 · Phone (386) 310-2160 · Fax (386) 310-2106

Location 2900 Village Square XingPalm Beach Gardens, FL 33410-4547 · Phone (561) 627-8500 · Fax (844) 959-0419

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha L Gullett Atc, Lat, Otc, Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335636240

PECOS Enrollment IDI20251014003773

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Fish Memorial

Acute Care Hospitals · Orange City, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100072

Location1055 Saxon BlvdOrange City, FL 32763 · Volusia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33463 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

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$73.00 typical visit price

range $18.44 – $144.68

Typical copayment $18.25 (range $4.61 – $36.17)

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 8

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

DR. DEVIN QUINTIN JOHN MD

Student in an Organized Health Care Education/Training Program