Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jeuelle M Ottley Sam, PA-C

Individual provider Physician Assistant · NPI 1740341924

Mrs. Jeuelle M Ottley Sam, PA-C is a Physician Assistant in Takoma Park, Maryland. Qualified in 2021, 5 years ago. Practices with Thriving Lane, a 24-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
5
Licensed in
MD
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7610 Carroll Ave Ste 200
Takoma Park, MD 20912-6384
Phone: (301) 891-2077
Fax: (301) 891-2080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0002743 (MD)

Record details

NPI number1740341924
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 12, 2006
Last updated in NPPESMarch 5, 2021
Certification dateMarch 5, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Thriving Lane — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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