NPIMap

Individual provider Active NPI

Samuel Iden, MD

  • Emergency Medicine Physician
  • Richmond, IN
National Provider Identifier
1144388471
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01060922 Issued in IN
Practice address
1100 Reid Pkwy
Richmond, IN 47374-1157
Phone
(317) 217-3000
Fax
(317) 870-0499
NPI assigned
Dec 6, 2006
Last updated
May 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01060922 IN Primary

Addresses

Primary practice location

1100 Reid Pkwy
Richmond, IN 47374-1157

Mailing address

1100 Reid Parkway
Medical Staff Services
Richmond, IN 47374
Phone (765) 983-3127

Other identifiers 1

IdentifierTypeStateIssuer
200844460MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address siden304839@ReidHealth.direct-ci.com Reid Physician Associates, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20070525000295 IN Practitioner - Emergency Medicine 2163529108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060922INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reid Physician Associates, Inc. CurrentSince Feb 24, 2019 Accepting new patients
Reid Physician Associates, Inc CurrentSince Feb 24, 2019 Accepting new patients
Reid Hospital & Health Care Services Inc Past Accepting new patients

Locations

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

Interoperability endpoints

  • Direct secure messaging: siden304839@reidhealth.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Reid HealthRichmond, IN, CCN 150048 Hospital Corporate Officer Jan 1, 2024
Reid HealthRichmond, IN, CCN 15T048 Hospital Corporate Officer Jan 1, 2024
Reid HealthRichmond, IN, CCN 151524 Hospice Corporate Officer (100%) Jan 1, 2024
Reid Primary & Specialty Care - Cambridge CityCambridge City, IN, CCN 153896 Rural health clinic Corporate Officer Jan 1, 2024

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1144388471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PARKWAY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "47374",
            "telephone_number": "765-983-3127",
            "fax_number": "765-983-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "317-217-3000",
            "fax_number": "317-870-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDEN",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01060922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200844460",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "siden304839@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.