Anna Nikolaevna Samedova, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

302842 Issued in NY

Practice address

854 Route 212
Saugerties Wellness Center
Saugerties, NY 12477-4619

Phone

(845) 246-2804

NPI assigned

May 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Anna Sevilla Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Family PracticeAlso: Hospitalist

Education

Rowan University School of Osteopathic Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archcare at Home Home health agency, Valhalla, NY, CCN 337140
• Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224
• Columbia Memorial Hospital Hospital, Hudson, NY, CCN 330094
• Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asamedova834733@direct.trinity-health.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.

• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Nuvance Health Medical Practice PC

  • Internal Medicine Physician
  • Poughkeepsie, NY
  • NPI 1437358033
  Medicare reassignment NPD
• St. Peter'S Health Partners Medical Associates, P.C.

  • Pediatrics Physician
  • Slingerlands, NY
  • NPI 1669717260
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Memorial Hospital

  • General Acute Care Hospital
  • Hudson, NY
  • NPI 1528024718
  Care Compare affiliation
• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599
  Care Compare affiliation
• Northern Dutchess Hospital

  • General Acute Care Hospital
  • Rhinebeck, NY
  • NPI 1124072715
  Care Compare affiliation
• The Dominican Sisters Family Health Service Inc

  • Home Health Agency
  • Valhalla, NY
  • NPI 1821184839
  Care Compare affiliation

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1023546348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 ROUTE 212",
            "address_2": "SAUGERTIES WELLNESS CENTER",
            "city": "SAUGERTIES",
            "state": "NY",
            "postal_code": "124774619",
            "telephone_number": "845-246-2804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Family Practice Dr",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124016449",
            "country_code": "US",
            "telephone_number": "845-338-6400",
            "fax_number": "845-339-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMEDOVA",
        "first_name": "ANNA",
        "middle_name": "NIKOLAEVNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "302842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "854 Route 212",
            "city": "Saugerties",
            "state": "NY",
            "country_code": "US",
            "postal_code": "124774619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "SEVILLA",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gregg Elwood Ross, RN
• Sudeep Jabaraj Ross, M.D.
• Clare Rubin, PT
• Tammy Russell, LPN
• Abbie Sagastume
• Maria Sanchez
• Anthony Sasso
• Saugerties Central School District
• Saugerties Central Schools
• Saugerties Chiropractic PC

• Family Medicine Physician in Saugerties, NY
• Providers in Saugerties, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.