Samuel Schaffer, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

20066 Issued in NY

Practice address

2110 Wallace Ave
1A
Bronx, NY 10462

Phone

(718) 829-5060

Fax

(718) 829-5060

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104895218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#1 STANDISH PLACE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "10530",
            "telephone_number": "914-693-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 WALLACE AVE",
            "address_2": "1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10462",
            "telephone_number": "718-829-5060",
            "fax_number": "718-829-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFER",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "20066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00287009",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Schadt, DMD 5/17/15
• Emily Schaefer
• Anne Marie Schaepers, RPA-C
• Bryan Schaf, MD
• Elisabeth Morgan Schaffer, OD
• Samantha Z Schafler, OTR/L
• Scott Jason Schafler, M.D.
• Kathryn Scharbach, M.D.
• Anna Scharfen, DDS
• Lindsey Brooke Scharfman, MD

• Dentist in Bronx, NY
• Providers in Bronx, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.