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

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: July 19, 2026.

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

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
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

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.

Student in an Organized Health Care Education/Training Program
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Student in an Organized Health Care Education/Training Program
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Student in an Organized Health Care Education/Training Program
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Durable Medical Equipment & Medical Supplies
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Physician Assistant (Surgical)
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Physician Assistant (Surgical)
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Physical Therapy Assistant
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463
Physical Therapy Assistant
4560 LANTANA RD STE 100
LAKE WORTH, FL 33463

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1841888773, enumerated as an "individual" on January 06, 2021.

The provider is located at 4560 LANTANA RD STE 100 LAKE WORTH, FL 33463 and the phone number is (561) 967-4400.

Physician Assistant with taxonomy code 363A00000X.

Samantha Gullett is affiliated with: ADVENTHEALTH FISH MEMORIAL.