Active NPI 1699274993 Individual Practitioner Male Practitioner

Samuel Robert Jackson , PA

Physician Assistant • Roanoke, VA

Professional Overview & Biography Verified Profile Summary

Samuel Jackson, PA is a registered healthcare professional specializing in Physician Assistant in Roanoke, VA. Practice services are available at 1906 BELLEVIEW AVE SE under active NPI credentials.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making, emergency department visit with low level of medical decision making. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1906 Belleview Ave Se

Roanoke, VA 240141838

Telephone 5409817000

Associated Practice Facility / Clinic

🏢 Carilion Medical Center Facility NPI 1033102942

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Roanoke, VA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 8.4 Yrs

State Avg: 10.5 Yrs

Regional Practice Density

301 Specialists

Practicing in Roanoke, VA (4432 Statewide)

Telehealth Adoption Rate

13.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

91.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	68	67	$1771.00	$141.86
99284 Emergency department visit with moderate level of medical decision making	37	37	$1038.68	$97.94
99283 Emergency department visit with low level of medical decision making	20	18	$813.00	$57.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99284 Emergency department visit with moderate level of medical decision making	26	24	$1195.77	$100.00
99285 Emergency department visit for life threatening or functioning severity	25	25	$1847.32	$145.36
99283 Emergency department visit with low level of medical decision making	11	11	$807.00	$59.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	79	73	$1812.52	$149.90
99284 Emergency department visit with moderate level of medical decision making	52	51	$1154.88	$103.14
99283 Emergency department visit with low level of medical decision making	23	23	$781.43	$61.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	146	144	$1632.53	$154.05
99284 Emergency department visit with moderate level of medical decision making	90	89	$984.21	$105.63
99283 Emergency department visit with low level of medical decision making	50	49	$723.62	$62.14
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	16	16	$80.00	$7.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	311	116	$206.09	$58.91
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	290	110	$205.28	$58.97
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	286	106	$269.82	$77.69
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	249	121	$270.24	$77.58
99335 Established patient assisted living visit, typically 25 minutes	208	76	$282.78	$81.62
99336 Established patient assisted living visit, typically 40 minutes	90	48	$401.00	$115.47
99285 Emergency department visit for life threatening or functioning severity	39	39	$1552.85	$149.11
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	36	33	$134.89	$37.64
99284 Emergency department visit with moderate level of medical decision making	31	31	$891.26	$101.13
99283 Emergency department visit with low level of medical decision making	19	19	$715.68	$55.70
99334 Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes	18	18	$190.00	$51.64
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	15	14	$133.80	$37.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	457	216	$263.67	$77.08
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	341	178	$200.24	$57.97
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	147	95	$263.90	$77.08
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	116	60	$200.93	$57.97
99335 Established patient assisted living visit, typically 25 minutes	93	46	$278.00	$80.12
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	58	48	$130.07	$37.06
99316 Nursing facility discharge management, more than 30 minutes	47	45	$301.66	$89.07
99315 Nursing facility discharge day management, 30 minutes or less	34	33	$210.94	$61.85
99336 Established patient assisted living visit, typically 40 minutes	33	22	$393.00	$114.17
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	28	26	$129.29	$37.06
99316 Nursing facility discharge management, more than 30 minutes	24	24	$300.25	$89.07
99334 Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes	17	14	$186.00	$50.81
99285 Emergency department visit for life threatening or functioning severity	15	15	$1604.33	$146.12
99284 Emergency department visit with moderate level of medical decision making	15	15	$850.60	$99.22
99283 Emergency department visit with low level of medical decision making	12	12	$737.00	$52.29

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License VA 0110006058

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Alfred Shilling , MD

Radiology - Diagnostic Radiology

NPI 1003029620

Doctor of Medicine (M.D.)

John Thompson , PA-C, ATC

Physician Assistant

NPI 1003176108

Physician Assistant (Certified), Certified Athletic Trainer

Dr. James Light , MD

Anesthesiology

NPI 1003234949

Doctor of Medicine (M.D.)

Dr. Sujina Pradhan , MD

Family Medicine

NPI 1003260373

Doctor of Medicine (M.D.)

Dr. Sammy Elsarrag , MD

Anesthesiology

NPI 1003348848

Doctor of Medicine (M.D.)

Dr. Nima Jahromi , DO

Student in an Organized Health Care Education/Training Program

NPI 1003504184

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 02, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location February 02, 2018

Registered at 1906 BELLEVIEW AVE SE, ROANOKE, VA 240141838 (Tel: 5409817000)

📍

Updated Business Mailing Address February 02, 2018

Registered at 719 ARBUTUS AVE SE, ROANOKE, VA 240142503 (Tel: 4049835673)

👤

Provider Name / Credentials Updated February 02, 2018

Recorded as SAMUEL JACKSON, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 02, 2018

Physician Assistant (License #0110006058 in VA)

🟢

Initial NPI Registration & Enumeration February 02, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699274993

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 02, 2018

Last Update: February 02, 2018

Sole Proprietor: No

Update or Correct Profile

Mailing Address

719 Arbutus Ave Se

Roanoke, VA 240142503

Phone: 4049835673

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.