Samuel K St Clair, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

39097 Issued in NC

Practice address

4207 Lake Boone TRL Ste 220
Raleigh, NC 27607-6685

Phone

(919) 784-1410

NPI assigned

Feb 22, 2006

Last updated

Jul 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: sstclair11701@direct.unc.nchie.net

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

• Neurosurgical Associates, P.C.

  • Neurological Surgery Physician
  • Raleigh, NC
  • NPI 1144295270
  Authorized official Same address or phone
• Raleigh Neurosurgical Clinic, Inc.

  • Neurological Surgery Physician
  • Raleigh, NC
  • NPI 1598702490
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1073588000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "STE 202",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-235-0500",
            "fax_number": "919-235-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 LAKE BOONE TRL STE 220",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076685",
            "telephone_number": "919-784-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Lake Boone Trl",
            "address_2": "STE 202",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077512",
            "country_code": "US",
            "telephone_number": "919-235-0500",
            "fax_number": "919-235-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST CLAIR",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NC",
            "license": "39097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "56219447701",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE NETWORK",
            "identifier": "706943",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "79535",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8979535",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0650385",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2070150",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "140006908",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "97486",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4063806",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanika Nykia Squirewell
• Rosario Sralla, LPC
• Megan Marie Sredl, MSN, FNP-BC
• Sachin Sreenivasan, MD
• Abhishek Sripad, MD
• St Home Healthcare Services LLC
• St Jude Medical Supply
• Natasha St. Fort
• Kyle M St. Jean, CRNA
• Tanya St. Julien, LPC

• Neurological Surgery Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Neurological Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.