Samuel Pennella Jr., MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301510893 Issued in MI

Practice address

607 Shelby St Ste 700
Detroit, MI 48226-3282

Phone

(908) 208-8926

NPI assigned

Apr 2, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

General Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medilodge of Frankenmuth Nursing home, Frankenmuth, MI, CCN 235175

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pennella Integrated Health PLLC

  • General Practice Physician
  • Detroit, MI
  • NPI 1508702333
  NPD (past) Authorized official
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025
  NPD

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

• Frankenmuth Opco, LLC

  • Skilled Nursing Facility
  • Frankenmuth, MI
  • NPI 1427455641

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1124524038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GLENNON FARM LN",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088334504",
            "telephone_number": "908-208-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 SHELBY ST STE 700",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482263282",
            "telephone_number": "908-208-8926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Glennon Farm Ln",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NJ",
            "postal_code": "088334504",
            "country_code": "US",
            "telephone_number": "908-208-8926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNELLA",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "68449",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "TW00059",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "TPME2986",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0074417",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301510893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charday Penick, LLBSW
• Michael James Peniston, MD
• Rena Lashaun Penn, RN
• Sylvia E Penn, BSW
• Pennella Integrated Health PLLC
• Andrea Pennington
• Penny Love LLC
• Penny Transportation
• Hayward S Penny, M.S., R.D.N
• Alicia Pennymon, CPRM

• General Practice Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.