Samuel David Echeverri, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MA09131000 Issued in NJ

Practice address

435 South St Ste 230B
Morristown, NJ 07960-6477

Phone

(973) 267-2838

NPI assigned

Sep 26, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

General Surgery

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
• Saint Clare's Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050
• Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group
• Ahs Hospital Corp

  dba AHS Consolidated Labs

  • Clinical Medical Laboratory
  • Morristown, NJ
  • NPI 1871162834
  NPD (past)
• Norman B San Agustin MD PA

  • Specialist
  • Morristown, NJ
  • NPI 1336263466

  Surgery

  NPD (past)
• Stafford Surgical Specialists, LLC

  • Surgery Physician
  • Manahawkin, NJ
  • NPI 1952540395
  NPD (past)

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

• Ahs Hospital Corp

  • General Acute Care Hospital
  • Hackettstown, NJ
  • NPI 1518969419
  Care Compare affiliation
• Ahs Hospital Corp.

  dba Morristown Medical Center

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation
• Ahs Hospital Corp.

  dba Chilton Medical Center

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation
• Prime Healthcare Services - Saint Clare's LLC

  dba Saint Clare's Hospital

  • General Acute Care Hospital
  • Denville, NJ
  • NPI 1598144362
  Care Compare affiliation

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174874481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SOUTH ST STE 230B",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606477",
            "telephone_number": "973-267-2838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Route 72 W",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Manahawkin",
            "state": "NJ",
            "postal_code": "080502468",
            "country_code": "US",
            "telephone_number": "609-978-3202",
            "fax_number": "609-978-3123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECHEVERRI",
        "first_name": "SAMUEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA09131000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "25MA09131000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila J Dynan, LCSW
• Ellen M Early, M.D.
• East Orange Vamc
• Murla Ecclesiaste, ARNP
• Rodrigo I Echeverri, DMD
• Chelsea Eckert
• Jessica Eckert, DO
• Devin Brazill Eckstein, D.O
• Osemeke S Edobor, M.D.
• John Edoga, M.D.

• Surgery Physician in Morristown, NJ
• Providers in Morristown, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.