Individual provider Active NPI

Sam Methratta, PHARMD

  • Pharmacist
  • Roslindale, MA
National Provider Identifier
1053052001
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
53025 Issued in TX
Practice address
30 Belgrade Ave
Roslindale, MA 02131-3006
Phone
(617) 363-1726
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 53025 TX Primary

Addresses

Primary practice location

30 Belgrade Ave
Roslindale, MA 02131-3006

Mailing address

30 Belgrade Ave
Roslindale, MA 02131-3006
Phone (617) 363-1726

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
53025TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sullivan'S Health Care, Inc CurrentSince Mar 11, 2025 Accepting new patients
Guardian Pharmacy of Texas LLC PastSince Apr 1, 2022 Accepting new patients

Organizations & group practices 2

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1053052001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BELGRADE AVE",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313006",
            "telephone_number": "617-363-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BELGRADE AVE",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313006",
            "telephone_number": "617-363-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METHRATTA",
        "first_name": "SAM",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "53025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.