Samaritan Sports Medicine PLLC
NPI 1407734031ActiveOrganization· Family Medicine, Sports Medicine· Raleigh, NC
Family Medicine, Sports Medicine in Raleigh, North Carolina, registered in NPPES in August 2025. The authorized official on file is Benjamin Martin Petty, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1407734031 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 22, 2025 |
| Last updated in NPPES | Aug 22, 2025 |
| Certified by provider | Aug 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Sports Medicine Primary | 207QS0010X | — | — |
| General Practice | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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