Disney Samutsakorn, PA-C
NPI 1255875571 · Physician Assistant · Fort Bragg, NC
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Disney Samutsakorn, PA-C is a Physician Assistant provider in Fort Bragg, NC (NPI 1255875571).
Provider details
- NPI number
- 1255875571
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1138817 (NC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (3)
- 1638 Owen DrFayetteville, NC 28304-3424Phone: (910) 615-6949
- 150 Robeson StFayetteville, NC 28301-5519Phone: (910) 615-1059
- 6387 Ramsey St Unit 100Fayetteville, NC 28311-9442Phone: (910) 615-7070
Registry dates
- Enumerated
- 2016-12-05
- Last updated
- 2025-11-17
- Certified
- 2025-11-17
Frequently asked questions
- What is Disney Samutsakorn's NPI number?
- Disney Samutsakorn's National Provider Identifier (NPI) is 1255875571, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Disney Samutsakorn's specialty?
- Disney Samutsakorn is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Disney Samutsakorn located?
- Disney Samutsakorn's practice location on file with NPPES is 2817 Rock Merritt Ave, Fort Bragg, NC 28310-4504.
- What is Disney Samutsakorn's phone number?
- The practice phone number listed in the NPPES registry for Disney Samutsakorn is (910) 907-8922.
- Does Disney Samutsakorn accept Medicare?
- Disney Samutsakorn is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Disney Samutsakorn's NPI active?
- Yes — Disney Samutsakorn's NPI (1255875571) is active in the NPPES registry as of the last update on 2025-11-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.