NPIMap

Individual provider Active NPI

Sangeeth Jonathan Samuel, M.D.

  • Family Medicine Physician
  • Texarkana, AR
National Provider Identifier
1134235146
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-4944 Issued in AR
Practice address
2109 White Oak LN
Texarkana, AR 71854-8120
Phone
(501) 664-6809
NPI assigned
Aug 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 E-4944 AR Primary

Addresses

Primary practice location

2109 White Oak LN
Texarkana, AR 71854-8120

Mailing address

2109 White Oak LN
Texarkana, AR 71854-8120
Phone (501) 664-6809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071025000351 AR Practitioner - Family PracticePractitioner - Emergency Medicine 9830286616 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Arkansas College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Medcare IncGroup PAC ID 5698667624, 53 clinicians

Practice addresses (Care Compare)

3050 Twin Rivers Dr
Arkadelphia, AR 71923-4218
Phone (501) 202-2300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monticello Ess LLC CurrentSince May 24, 2022 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Jan 1, 2017 Accepting new patients
Arkansas Heart Hospital Rural Health Services, LLC CurrentSince Mar 1, 2021 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Mar 1, 2021 Accepting new patients
Emergency Staffing Solutions Region III CurrentSince Sep 29, 2022 Accepting new patients
HCC of Magnolia LLC CurrentSince Sep 28, 2022 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Mar 1, 2021 Accepting new patients
Ess Hospitalist LLC CurrentSince Sep 28, 2022 Accepting new patients
Mabelvale Community Emergency Physicians Past Accepting new patients
Emergency Staffing Solutions Northeast Inc Past Accepting new patients
Hope-Hempstead Emegency Group LLC Past Accepting new patients
West Leslie ER Physicians LLC Past Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

2001 S Main St
Hope, AR 71801
Phone (870) 722-3800

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

101 Hospital Dr
Magnolia, AR 71753
Phone (870) 235-3000

311 Morrow St N
Mena, AR 71953
Phone (479) 394-6100

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134235146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 WHITE OAK LN",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718548120",
            "telephone_number": "501-664-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 WHITE OAK LN",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718548120",
            "telephone_number": "501-664-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SANGEETH",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-4944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

Verify at the official NPI Registry.