Individual provider Active NPI

Samuel Snyder, DO

  • Nephrology Physician
  • Boynton Beach, FL
National Provider Identifier
1093749111
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS 6909 Issued in FL
Practice address
2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone
(561) 292-4949
Fax
(561) 292-4612
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OS 6909 FL Primary

Addresses

Primary practice location

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969

Mailing address

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone (561) 292-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20041113000180 FL Practitioner - NephrologyPractitioner - Internal Medicine 3476517053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS 6909FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University, Inc CurrentSince Feb 1, 1995 Accepting new patients
Nova Southeastern University Inc. CurrentSince Feb 1, 1995 Accepting new patients
Nova Southeastern University, Inc Nephrology Past Accepting new patients

Locations

3200 S University Dr
Fl 1
Davie, FL 33328

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1093749111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S SEACREST BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357969",
            "telephone_number": "561-292-4949",
            "fax_number": "561-292-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S SEACREST BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357969",
            "telephone_number": "561-292-4949",
            "fax_number": "561-292-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "OS 6909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.