Individual provider Active NPI

Emily Samuels, MS RD

  • Registered Dietitian
  • Brookline, MA
National Provider Identifier
1033660972
Registry record updated Oct 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3054 Issued in MA
Practice address
1101 Beacon St
Suite 4W
Brookline, MA 02446-5587
Phone
(617) 680-3888
NPI assigned
Oct 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3054 MA Primary

Addresses

Primary practice location

1101 Beacon St
Suite 4W
Brookline, MA 02446-5587

Mailing address

1101 Beacon St
Suite 4W
Brookline, MA 02446-5587
Phone (617) 680-3888

Other names 1

  • Emma Samuels Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3054MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1476489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476489600000",
    "number": "1033660972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST",
            "address_2": "SUITE 4W",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-680-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST",
            "address_2": "SUITE 4W",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-680-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "EMILY",
        "credential": "MS RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-15",
        "last_updated": "2016-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "SAMUELS",
            "credential": "MS RD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.