Merson Samuel, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F303651 Issued in NY

Practice address

119 Fulton Ave
Garden City Park, NY 11040

Phone

(516) 877-8052

NPI assigned

Mar 30, 2007

Last updated

Aug 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: msamuel14651@nychhc.direct-ci.com

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1174643654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5555",
            "fax_number": "516-876-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 FULTON AVE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "516-877-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "MERSON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303651",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "431164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betcy Rajan, PHARMD
• Roshan Rao, PHARM D
• Fredric Barry Rapps, OPHTHALMIC DISPENSER
• Diane L Rodocker, M.S.,CCC
• Rosamma Saji, NP
• Karla Schacher, CNIM
• Janaki Narayanaswami Sengupta, MSC., RD, CDN,CDE
• Varsha C Shah
• Shree Raj Services Inc.
• Ann P Smollon, LCSW-R

• Adult Health Nurse Practitioner in Garden City Park, NY
• Providers in Garden City Park, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.