Individual provider Active NPI

Samir Patel, MD

  • Surgery Physician
  • Egg Harbor Township, NJ
National Provider Identifier
1124058698
Registry record updated Oct 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA07560600 Issued in NJ
Practice address
2500 English Creek Ave
BLDG. 800
Egg Harbor Township, NJ 08234-5549
Phone
(609) 407-2332
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA07560600 NJ Primary

Addresses

Primary practice location

2500 English Creek Ave
BLDG. 800
Egg Harbor Township, NJ 08234-5549

Mailing address

2500 English Creek Ave
Apg Specialty Care BLDG. 800
Egg Harbor Township, NJ 08234-5549
Phone (609) 407-2332

Other identifiers 1

IdentifierTypeStateIssuer
0001147MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100610000303 NJ Practitioner - General Surgery 7810027349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8146

2500 English Creek Ave
Egg Harbor Township, NJ 08234-5549

2500 English Creek Ave
Egg Harbor Township, NJ 08234-5598

459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225
Phone (609) 340-7815

Hospital & facility affiliations

  • Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064
  • Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07560600NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA Surgery Current Accepting new patients
Atlanticare Physician Group CurrentSince Mar 22, 2010 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Mar 22, 2010 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients
Atlanticare Physician Group Past Accepting new patients

Locations

2500 English Creek Ave
Ste 602
Egg Harbor Twp, NJ 08234
Phone (609) 272-6340

2500 English Creek Ave
Ste 800
Egg Hbr Twp, NJ 08234
Phone (609) 407-2277

219 N White Horse Pike
Ste 104
Hammonton, NJ 08037
Phone (609) 748-7300

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1124058698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "address_2": "APG SPECIALTY CARE BLDG. 800",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345549",
            "telephone_number": "609-407-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "address_2": "BLDG. 800",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345549",
            "telephone_number": "609-407-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07560600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001147",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.