Valsamma Samuel, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

136752-1 Issued in NY

Practice address

5 Grace Church St
Open Door Family Medical Centers, Inc.
Port Chester, NY 10573-4911

Phone

(914) 937-8899

NPI assigned

Dec 15, 2006

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

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1124180278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "VALSAMMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "136752-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00442411",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Rutherford
• S H Laufer of Port Chester Inc
• Luisa M Saavedra, MD
• Elizabeth Sabga
• Denise J Samaroo, OD
• Donna Santavicca, LMSW
• Aimie Sarkodie-Mensah-Best, MS, ATC
• Simona Saroyan, D.M.D
• Nicholas Saselu, RPH
• Jessica Schacker, OTR/L

• Pediatrics Physician in Port Chester, NY
• Providers in Port Chester, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.