NPIMap

Individual provider Active NPI

Sandeep Thomas Samuel, MD

  • Gastroenterology Physician
  • Harlingen, TX
National Provider Identifier
1174822647
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R1446 Issued in TX
Practice address
512 Victoria LN Ste 2
Harlingen, TX 78550-3227
Phone
(956) 365-4400
Fax
(956) 365-4111
NPI assigned
Mar 22, 2011
Last updated
Apr 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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 R1446 TX Primary

Addresses

Primary practice location

512 Victoria LN Ste 2
Harlingen, TX 78550-3227

Mailing address

512 Victoria LN Ste 2
Harlingen, TX 78550-3227
Phone (956) 365-4400

Other practice location 1

305 Lorenaly Dr
Brownsville, TX 78526-4333
Phone (956) 365-4400

Other identifiers 1

IdentifierTypeStateIssuer
370557603MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HARLINGEN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170522000130 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 7012219488 Reassigns benefits to 1 organization
I20180312000641 NH Practitioner - Gastroenterology 7012219488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Consultants of South Texas, PLLCGroup PAC ID 3274624937, 42 clinicians

Practice addresses (Care Compare)

512 Victoria LN
Suite 2
Harlingen, TX 78550-3227
Phone (956) 365-4400

720 N 77 Sunshinestrip
Harlingen, TX 78550-8848
Phone (956) 365-4400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy226
Upper gastrointestinal (GI) endoscopy for acid reflux297

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Hospital Association CurrentSince Feb 26, 2018 Accepting new patients
Littleton Hospital Association CurrentSince Feb 26, 2018 Accepting new patients
Hendrick Medical Center CurrentSince Mar 15, 2018 Accepting new patients
Hendrick Medical Center CurrentSince Mar 15, 2018 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Value Anesthesia Associates PLLC PastSince Nov 14, 2018 Accepting new patients
Yvonne E. Bracamontes, M.D. PA PastSince Apr 11, 2017 Accepting new patients

Locations

580 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-0385

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

Organizations & group practices 8

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 6

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1174822647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN STE 2",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503227",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN STE 2",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503227",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Lorenaly Dr",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TX",
            "postal_code": "785264333",
            "country_code": "US",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SANDEEP",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "R1446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370557603",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HARLINGEN",
            "affiliation": "N",
            "endpointDescription": "Office email",
            "address_1": "512 Victoria Ln Ste 2",
            "city": "Harlingen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785503227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.