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JENNIFER M SAMPLE PA-C
NPI 1902000714
Physician Assistant in Mentor, OH

Active since June 14, 2007PECOS EnrolledAccepts Medicare Assignment
9500 MENTOR AVE, SUITE 100, MENTOR, OH 44060(440) 352-4880(440) 352-3629 Get Directions Write a Review

NPPES record last updated: April 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jennifer M Sample Pa-c NPPES

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

JENNIFER M SAMPLE PA-C (NPI 1902000714) is an individual physician assistant in Mentor, Ohio, licensed in Ohio (2541) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS, is affiliated with Fairview Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1902000714
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJENNIFER M SAMPLECredential: PA-C
Location Address9500 MENTOR AVE, SUITE 100Mentor, OH 44060-8713
Mailing Address9500 Euclid AveCleveland, OH 44195-0001 · (440) 445-4500
Phone(440) 352-4880
Fax(440) 352-3629
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJune 14, 2007
Last NPPES UpdateApril 8, 2021
NPPES CertifiedApril 8, 2021
✔ NPI 1902000714 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 OH · 2541
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.
9500 MENTOR AVE, Mentor, OH 44060
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Ohio, Inc., CareSource, MedMutual.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

Jennifer M Sample 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 ID3779620158
PECOS Enrollment IDI20091019000155
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 2

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

Fairview Hospital

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360077
Location18101 Lorain AvenueCleveland, OH 44111 · Cuyahoga County
Emergency services Birthing friendly

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44060 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

MARK K. KOMAR MD
Family Medicine
9500 MENTOR AVE, SUITE 100
MENTOR, OH 44060
Lake County (440) 352-4880
JOHN S. BUCCHIERI M.D.
Orthopaedic Surgery
9500 MENTOR AVE, SUITE 210
MENTOR, OH 44060
Lake County (440) 352-1711
DR. ERIC M PARSONS M.D.
Orthopaedic Surgery
9500 MENTOR AVE, SUITE 210
MENTOR, OH 44060
Lake County (440) 352-1711
DR. PATRICK A QUINN MD
Obstetrics & Gynecology
9500 MENTOR AVE, SUITE 220
MENTOR, OH 44060
Lake County (440) 357-7100
MARC J. MCNAUGHTON MD
Family Medicine
9500 MENTOR AVE, SUITE 100
MENTOR, OH 44060
Lake County (440) 350-4880
DR. STEPHEN T CAROSELLO DDS
Dentist (General Practice)
9500 MENTOR AVE, STE 280
MENTOR, OH 44060
Lake County (440) 352-2887
DR. JEFFREY C LUPICA DPM
Podiatrist
9500 MENTOR AVE, SUITE 210
MENTOR, OH 44060
Lake County (440) 352-1711
MS. ELIZABETH WOJCIK P.T.
Physical Therapist
9500 MENTOR AVE, SUITE 210
MENTOR, OH 44060
Lake County (440) 352-0934

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 Jennifer Sample's NPI number?

The NPI number for Jennifer Sample is 1902000714. It was assigned to this individual provider in the NPPES registry on June 14, 2007.

Where is Jennifer Sample located?

Jennifer Sample practices at 9500 Mentor Ave Suite 100, Mentor, OH 44060. The listed phone number is (440) 352-4880.

What is Jennifer Sample's specialty?

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

Is Jennifer Sample enrolled in Medicare?

Yes. Jennifer Sample 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.

What insurance does Jennifer Sample accept?

Health plans from Antidote Health Plan of Ohio, Inc., CareSource and MedMutual list Jennifer Sample as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jennifer Sample affiliated with any hospitals?

According to CMS data, Jennifer Sample is affiliated with Fairview Hospital and Cleveland Clinic.

When was this NPI record last updated?

The NPPES record for Jennifer Sample was last updated on April 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.