NPIMap

Individual provider Active NPI

Syed Abdus Samad, MD

  • Gastroenterology Physician
  • Pine Bluff, AR
National Provider Identifier
1174585814
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R4495 Issued in AR
Practice address
4800 Hazel St
Pine Bluff, AR 71603
Phone
(870) 534-5533
Fax
(870) 534-5535
NPI assigned
Apr 6, 2006
Last updated
Aug 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X R4495 AR Primary

Addresses

Primary practice location

4800 Hazel St
Pine Bluff, AR 71603

Mailing address

PO Box 2797
Pine Bluff, AR 71613-2797
Phone (870) 534-5533

Other identifiers 3

IdentifierTypeStateIssuer
12162000000OtherQUAL CHOICE
5J068OtherARBLUE CROSS BLUE SHIELD
123407001MedicaidAR

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
I20040310001072 AR Practitioner - GastroenterologyPractitioner - Internal Medicine 4284522194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Care P aGroup PAC ID 7810011905, 4 clinicians

Practice addresses (Care Compare)

4800 S Hazel St
Pine Bluff, AR 71603-6860
Phone (870) 534-5533

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.66 of 100Reported as group
Quality
93.33
Improvement activities
40
Cost
45.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4495ARMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Care PA Gastroenterology CurrentSince Jul 1, 1994 Accepting new patients
Digestive Care P a Gastroenterology CurrentSince Jul 1, 1994 Accepting new patients
Arkansas Surgery & Endoscopy Center PastSince Aug 14, 2006 Accepting new patients
ASC Anesthesia, PLLC PastSince Mar 1, 2016 Accepting new patients
Arkansas Surgery & Endoscopy Center Past Accepting new patients
Central Arkansas Surgical Center, LLC PastSince Jun 1, 2025 Accepting new patients

Locations

4800 S Hazel St
Pine Bluff, AR 71603
Phone (870) 534-5533

Organizations & group practices 7

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 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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1174585814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716132797",
            "telephone_number": "870-534-5533",
            "fax_number": "870-534-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HAZEL ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-534-5533",
            "fax_number": "870-534-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAD",
        "first_name": "SYED",
        "middle_name": "ABDUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "R4495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "12162000000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5J068",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123407001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.