Individual provider Active NPI

Samuel Antwi, FNP-BC, PHD

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1144528209
Registry record updated Dec 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN1027557 Issued in DC
Practice address
1601 18TH St NW Ste 4
Washington, DC 20009-2505
Phone
(202) 223-0969
Fax
(202) 223-0963
NPI assigned
Mar 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN1027557 DC Primary

Addresses

Primary practice location

1601 18TH St NW Ste 4
Washington, DC 20009-2505

Mailing address

1601 18TH St NW Ste 4
Washington, DC 20009-2505
Phone (202) 223-0969

Other identifiers 3

IdentifierTypeStateIssuer
068468600MedicaidMD
2013242030MedicaidVA
047277600MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130502000069 DC Practitioner - Nurse Practitioner 8224275623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2141 K St NW
Suite 607
Washington, DC 20037-1810
Phone (202) 223-0969

Hospital & facility affiliations

  • George Washington Univ Hospital Hospital, Washington, DC, CCN 090001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Sam Medical Center of America PLLC CurrentSince Feb 20, 2013 Accepting new patients
Sam Medical Center of America PLLC Current Accepting new patients

Locations

2141 K St NW
Ste 607
Washington, DC 20037
Phone (202) 223-0969

1601 18th St NW
Ste 4
Washington, DC 20009
Phone (202) 223-0969

Organizations & group practices 2

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.

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": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1144528209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 18TH ST NW STE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092505",
            "telephone_number": "202-223-0969",
            "fax_number": "202-223-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 18TH ST NW STE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092505",
            "telephone_number": "202-223-0969",
            "fax_number": "202-223-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTWI",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "FNP-BC, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-14",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1027557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068468600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013242030",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047277600",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.