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

Individual provider Medical Physician Assistant · NPI 1770393415

Travis Samples, PA-C is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2024, 2 years ago. Practices with Professional Emergency Physicians PC, a 75-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2025
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

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone: (260) 482-5091
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10004770A (IN)

Record details

NPI number1770393415
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 13, 2025
Last updated in NPPESMarch 27, 2026
Certification dateMarch 27, 2026
Mailing address608 Union Chapel Rd, Fort Wayne, IN 46845-9357

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Professional Emergency Physicians Pc — 75 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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