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

Samantha Lynn Pavolko

Individual provider Physical Therapy Clinic/Center · NPI 1689438087

Samantha Lynn Pavolko is a Physical Therapist in Private Practice in Moosic, Pennsylvania. Qualified in 2023, 3 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
3
Licensed in
PA
In the registry since
2024
Specialties on file
2

Practice location Address checks out

3356 Birney Plz
Moosic, PA 18507-1560
Phone: (570) 347-7790
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT032106 (PA)
Physical Therapy Clinic/Center Taxonomy 261QP2000X · Licence PT032106 (PA)

Record details

NPI number1689438087
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 7, 2024
Last updated in NPPESFebruary 7, 2024
Certification dateFebruary 7, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Moosic