Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heather Samudovsky, PA-C

Individual provider Physician Assistant · NPI 1356962120

Heather Samudovsky, PA-C is a Physician Assistant in Springfield, Illinois. Qualified in 2020, 6 years ago. Practices with Swansea Medical Group Ltd, a 3-clinician group. Licensed in Illinois.

Years since qualifying
6
Licensed in
IL
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

800 E Carpenter St
Springfield, IL 62769-4902
Phone: (217) 544-6464
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-007904 (IL)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1356962120
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 2, 2020
Last updated in NPPESMarch 7, 2024
Certification dateMarch 7, 2024
Mailing address111 Oakwood Rd, East Peoria, IL 61611-1853

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Swansea Medical Group Ltd — 3 clinicians
Accepts Medicare assignment Not indicated

Other providers in Springfield