South Side Convenient Care Inc
NPI 1679007249ActiveOrganization· Physician Assistant· Bellevue, NE
Physician Assistant in Bellevue, Nebraska, registered in NPPES in April 2017. The authorized official on file is Samantha Senanayaka, PA-C, Clinic Credentialing Contact. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1679007249 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 20, 2017 |
| Last updated in NPPES | Jul 17, 2023 |
| Certified by provider | Jul 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NE) |
|---|
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