Maryan Samsom, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01085320A Issued in IN

Practice address

2001 W 86TH St
Indianapolis, IN 46260-1902

Phone

(317) 338-2345

NPI assigned

Apr 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Physician Services Hospital and Health Care CenterGroup PAC ID 9638072184, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
• Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375
  Medicare reassignment
• St Vincent Physician Services Hospital and Health Care Center

  • Durable Medical Equipment & Medical Supplies
  • Carmel, IN
  • NPI 1366689044
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation
• Union Hospital Inc.

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1619975331
  Care Compare affiliation
• Union Hospital, Inc

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1821859752
  Care Compare affiliation

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1104313832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 State Route 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-776-4483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSOM",
        "first_name": "MARYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01085320A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Sampson
• Humraaz Samra
• Sams East Inc
• Sams East Inc
• Shana Sams
• Jessica Samson, PA-C
• Kelly Akin Samson, M.S., C.G.C.
• Puja G Samudra, MD
• Samuel M. Smith, Ma, LMFT, LMHC
• Jessica Samuel, PHARMD

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.