Prudencio Gabriel Samson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C53191 Issued in CA

Practice address

720 Sunrise Ave Ste 202C
Roseville, CA 95661-4509

Phone

(530) 341-2521

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Gary Samson Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellspace HealthGroup PAC ID 8426157975, shared by 17 NPIs, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gsamson770267@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Colusa

  • Community/Behavioral Health Agency
  • Colusa, CA
  • NPI 1902929052
  Medicare reassignment NPD
• County of Sacramento

  • Adult Mental Health Clinic/Center
  • Sacramento, CA
  • NPI 1043386659
  Medicare reassignment NPD
• Hisham Soliman MD Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Folsom, CA
  • NPI 1700199080

  Psychiatry

  Medicare reassignment NPD
• County of Sacramento

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1508936030
  NPD
• County of Sacramento

  • Adult Mental Health Clinic/Center
  • Sacramento, CA
  • NPI 1750601704
  NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Citrus Heights, CA
  • NPI 1215350848
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1013045863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SUNRISE AVE STE 202C",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614509",
            "telephone_number": "860-881-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 SUNRISE AVE STE 202C",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614509",
            "telephone_number": "530-341-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "PRUDENCIO",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "034209",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C53191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "SAMSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fred Samimi, M.D.
• Ahmad F. Samir, MD
• Delinda Rose Samp, LMFT 110181
• Sams West Inc
• Samson Psychiatry Inc.
• Jason Samuels
• Alma Sanchez-Segura
• Alexandria Guadalupe Sanchez
• Ariella Sanchez
• Jamie Ann Sanchez, AMFT

• Psychiatry Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.