Samuel Selasie Mortoti, MBCHB

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

E-7981 Issued in AR

Practice address

2000 McLain St
Suite H
Newport, AR 72112-3661

Phone

(870) 523-2404

NPI assigned

May 21, 2008

Last updated

Aug 1, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in IL

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 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Graham Hospital Association Hospital, Canton, IL, CCN 140001
• Graham Hospital Association Hospital, Canton, IL, CCN 141356
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Harris Medical Clinics Inc

  dba Harris Podiatry Clinic

  • Durable Medical Equipment & Medical Supplies
  • Newport, AR
  • NPI 1609178359
  NPD (past)
• Harris Medical Clinics Inc.

  • Family Medicine Physician
  • Newport, AR
  • NPI 1588663660
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1154588762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 DEERFIELD DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048467",
            "telephone_number": "202-290-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MCLAIN ST",
            "address_2": "SUITE H",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721123661",
            "telephone_number": "870-523-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTOTI",
        "first_name": "SAMUEL SELASIE",
        "name_prefix": "Dr.",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-7981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael W. Brown, DDS
• Monette Manor, LLC
• Kiara Moody
• Jymmeka Moore, PLMSW
• Luvnia Morgan, RECOVERY ASSISTANT
• Patti J Mullins, DDS
• Melvin Nance, M.D.
• National Healthcare of Newport Inc (Harris Hospital ER)
• National Healthcare of Newport Inc (Harris Anesthesia Associates)
• National Healthcare of Newport Inc (Harris Hospital)

• Cardiovascular Disease Physician in Newport, AR
• Providers in Newport, AR by specialty
• Cardiovascular Disease Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.