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SAMANTHA RILEY PA-C
NPI 1881309326
Physician Assistant in Port Jefferson, NY

Active since January 19, 2023PECOS EnrolledAccepts Medicare Assignment
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 473-1320 Get Directions Write a Review

NPPES record last updated: April 27, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Samantha Riley Pa-c NPPES

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

SAMANTHA RILEY PA-C (NPI 1881309326) is an individual physician assistant in Port Jefferson, New York and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1881309326
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSAMANTHA RILEYCredential: PA-C
Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2190
Mailing Address75 N Country RdPort Jefferson, NY 11777-2119
Phone(631) 473-1320
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 19, 2023
Last NPPES UpdateApril 27, 2025
NPPES CertifiedApril 27, 2025
✔ NPI 1881309326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
75 N COUNTRY RD, Port Jefferson, NY 11777
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Other Names 1

Former Name (1)Samantha Gagnon

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 Riley Pa-c 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 ID3375917172
PECOS Enrollment IDI20230317001283
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 3

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

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
71 services66 patients
Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less 12001
This is a procedure to fix a minor wound on your scalp, neck, underarms, trunk, arms, or legs that is 2.5 cm or less. It involves cleaning, and then stitching or gluing the wound to help it heal properly and minimize scarring.
12 services12 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

John T Mather Memorial Hospital Of Port Jefferson

Acute Care Hospitals · Port Jefferson, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330185
Location75 North Country RoadPort Jefferson, NY 11777 · Suffolk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11777 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

JUSTINA CATHERINE MELLONE DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
AAKAASH VARMA MD
Dermatology
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KRISELA VOJNIKU MD
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
LORETTA DIDWELL
Physician Assistant
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
RAYMOND WONG
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-7654
KATLYN ANN CONVILLE ANTHONY NP
Nurse Practitioner (Family)
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2565
SHEHNAZ WASIM MD
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-1443
JULIA KOROBENKO DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549

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 Samantha Riley's NPI number?

The NPI number for Samantha Riley is 1881309326. It was assigned to this individual provider in the NPPES registry on January 19, 2023. The provider is also known as Samantha Gagnon.

Where is Samantha Riley located?

Samantha Riley practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-1320.

What is Samantha Riley's specialty?

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

Is Samantha Riley enrolled in Medicare?

Yes. Samantha Riley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Samantha Riley affiliated with any hospitals?

According to CMS data, Samantha Riley is affiliated with John T Mather Memorial Hospital Of Port Jefferson.

When was this NPI record last updated?

The NPPES record for Samantha Riley was last updated on April 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.