Individual provider Active NPI

Eman Hussain Al-Samrrai, M.D.

  • Family Medicine Physician
  • Annapolis, MD
National Provider Identifier
1093828501
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D69561 Issued in MD
Practice address
1419 Forest Dr
Annapolis, MD 21403-1482
Phone
(410) 990-0050
NPI assigned
Aug 17, 2006
Last updated
Jun 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D69561 MD Primary

Addresses

Primary practice location

1419 Forest Dr
Annapolis, MD 21403-1482

Mailing address

10611 Hickory PT
Columbia, MD 21044-4069
Phone (410) 730-5588

Other identifiers 1

IdentifierTypeStateIssuer
420337200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20111213000436 MD Practitioner - Family Practice 2860448073 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5890 Waterloo Rd
Columbia, MD 21045-2617
Phone (667) 214-1800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Aug 5, 2019 Accepting new patients
Luminis Health Community Clinics, LLC Family Medicine CurrentSince Aug 7, 2013 Accepting new patients
Luminis Health Community Clinics, LLC Family Medicine CurrentSince Aug 7, 2013 Accepting new patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Aug 5, 2019 Accepting new patients
University of Maryland Faculty Physicians Immediate Care, LLC CurrentSince Aug 5, 2019 Accepting new patients
Express Healthcare, LLC Past Accepting new patients
Sleep Insights Medical Services, LLC PastSince Dec 1, 2015 Accepting new patients
Olean Open MRI PC Past Accepting new patients

Locations

1419 Forest Dr
Annapolis, MD 21403
Phone (410) 990-0050

92 W Washington St
Annapolis, MD 21401
Phone (410) 269-9060

5890 Waterloo Rd
Columbia, MD 21045
Phone (410) 328-2603

Interoperability endpoints

  • Direct secure messaging: ealsamrrai643808@direct.umm.edu
  • FHIR API: https://api.platform.athenahealth.com/22039/brand/2/csg/1/fhir/r4

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1093828501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 HICKORY PT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444069",
            "telephone_number": "410-730-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 FOREST DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214031482",
            "telephone_number": "410-990-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-SAMRRAI",
        "first_name": "EMAN",
        "middle_name": "HUSSAIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D69561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420337200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.