Individual provider Active NPI

Brad Gregory Samojla, DPM

  • Podiatrist
  • Belfast, ME
National Provider Identifier
1124137138
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD243 Issued in ME
Practice address
118 Northport Ave
Belfast, ME 04915-6009
Phone
(207) 930-2510
Fax
(207) 930-2512
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD243 ME Primary

Addresses

Primary practice location

118 Northport Ave
Belfast, ME 04915-6009

Mailing address

118 Northport Ave
Belfast, ME 04915-6009
Phone (207) 930-2510

Other identifiers 1

IdentifierTypeStateIssuer
431723799MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719000379 ME Practitioner - Podiatry 9537196837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Waldo Hospital Hospital, Belfast, ME, CCN 201312
  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD243MEMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jan 3, 1994 Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Waldo County General Hospital Past Accepting new patients
Waldo County General Hospital Past Accepting new patients
Lake Region Family Foot & Ankle Center PastSince Jan 31, 2010 Accepting new patients
Mainehealth Past Accepting new patients
Lake Region Foot and Ankle LLC Podiatrist Past Accepting new patients

Locations

118 Northport Ave
Belfast, ME 04915
Phone (207) 338-9345

116 Northport Ave
Ste 220
Belfast, ME 04915
Phone (207) 505-4015

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

4 Glen Cove Dr
Ste 204
Rockport, ME 04856
Phone (207) 594-4412

4 Glen Cove Dr
Ste 205
Rockport, ME 04856
Phone (207) 301-5700

Interoperability endpoints

  • Direct secure messaging: bsamojla101120@direct.mmc.mainehealth.org

Organizations & group practices 9

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 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1124137138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 NORTHPORT AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156009",
            "telephone_number": "207-930-2510",
            "fax_number": "207-930-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORTHPORT AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156009",
            "telephone_number": "207-930-2510",
            "fax_number": "207-930-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOJLA",
        "first_name": "BRAD",
        "middle_name": "GREGORY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ME",
            "license": "POD243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431723799",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfast, ME

Sources for this page

Verify at the official NPI Registry.