Bersabeh Mulugeta Samuel, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1146085 Issued in TX

Practice address

3001 E President George Bush Hwy Ste 210
Richardson, TX 75082-3552

Phone

(469) 204-9400

NPI assigned

Feb 14, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1154186765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 FOXBORO DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824124",
            "telephone_number": "832-798-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 E PRESIDENT GEORGE BUSH HWY STE 210",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823552",
            "telephone_number": "469-204-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "BERSABEH",
        "middle_name": "MULUGETA",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1146085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam's Medical Center PLLC
• Nasser Samadi, DC
• Jordan Sampson
• Carol Samson-Ibhagui
• Samuel W Robinson, DDS, PLLC (Richardson Oral & Maxillofacial Surgery)
• Lourdes San Cristobal
• Bryan Sanchez
• Christine Ann Sanchez, P.T.
• Stephanie Liner Sanchez, R.PH.
• Sanctuary Home Care LLC

• Acute Care Nurse Practitioner in Richardson, TX
• Providers in Richardson, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.