Individual provider Active NPI

Samuel P Eng, MD

  • Family Medicine Physician
  • Olney, MD
National Provider Identifier
1134199557
Registry record updated Oct 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0050207 Issued in MD
Practice address
18111 Prince Philip Dr
Suite #207
Olney, MD 20832-1507
Phone
(301) 774-7170
Fax
(301) 774-6676
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0050207 MD Primary

Addresses

Primary practice location

18111 Prince Philip Dr
Suite #207
Olney, MD 20832-1507

Mailing address

18111 Prince Philip Dr
Suite #207
Olney, MD 20832-1507
Phone (301) 774-7170

Other identifiers 1

IdentifierTypeStateIssuer
020201100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040329000644 MD Practitioner - Family Practice 0244122703 Reassigns benefits to 2 organizations
I20090807000475 DC Practitioner - Family Practice 0244122703

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Family Medicine Current Accepting new patients
Frederick Health Hospital Inc CurrentSince Feb 28, 2003 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1560 Opossumtown Pike
Frederick, MD 21702
Phone (301) 662-8866

1564 Opossumtown Pike
Frederick, MD 21702
Phone (301) 663-3137

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1134199557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE #207",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321507",
            "telephone_number": "301-774-7170",
            "fax_number": "301-774-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE #207",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321507",
            "telephone_number": "301-774-7170",
            "fax_number": "301-774-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "SAMUEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0050207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020201100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.