NPIMap

Individual provider Active NPI

Vijaya P Samuel, MD

  • Internal Medicine Physician
  • Overland Park, KS
National Provider Identifier
1104810803
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-29522 Issued in KS
Practice address
10601 Quivira Rd
Suite 200
Overland Park, KS 66215-2310
Phone
(913) 541-3340
Fax
(913) 492-7857
NPI assigned
Sep 8, 2005
Last updated
Oct 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04-29522 KS Primary

Addresses

Primary practice location

10601 Quivira Rd
Suite 200
Overland Park, KS 66215-2310

Mailing address

10601 Quivira Rd
Suite 200
Overland Park, KS 66215-2310
Phone (913) 541-3340

Other identifiers 3

IdentifierTypeStateIssuer
100425510CMedicaidKS
04-29522OtherKSMEDICAL LICENSE
1104810803MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111215000845 KS Practitioner - Internal Medicine 3577515139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quivira Internal Medicine IncGroup PAC ID 1355392457, 12 clinicians

Practice addresses (Care Compare)

10500 Quivira Rd
Overland Park, KS 66215-2306
Phone (913) 541-5000

10601 Quivira Rd
Suite 200
Overland Park, KS 66215-2320
Phone (913) 541-3340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.03 of 100Reported as individual
Quality
91.45
Improvement activities
40
Cost
58.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-29522KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quivira Internal Medicine Inc Internal Medicine CurrentSince Feb 1, 2005 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

10550 Quivira Rd
Ste 510
Overland Park, KS 66215
Phone (913) 492-5456

10601 Quivira Rd
Ste 200
Overland Park, KS 66215
Phone (913) 498-1134

Interoperability endpoints

  • Direct secure messaging: vijaya.samuel@hca2.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1104810803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 QUIVIRA RD",
            "address_2": "SUITE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152310",
            "telephone_number": "913-541-3340",
            "fax_number": "913-492-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 QUIVIRA RD",
            "address_2": "SUITE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152310",
            "telephone_number": "913-541-3340",
            "fax_number": "913-492-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "VIJAYA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-29522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100425510C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "04-29522",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104810803",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.