Active NPI
Samuel Robert Josephsen, MD
- Internal Medicine Physician
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD61501458
- Practice address
- 101 W 8TH Ave
Spokane, WA 99204-2307 - Phone
- (509) 474-3260
- NPI assigned
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD61501458 | WA | Primary |
Addresses
Primary practice location
101 W 8TH Ave
Spokane, WA 99204-2307
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 890-0931
Other practice location 1
624 E Front Ave
Spokane, WA 99202-2139
Phone (509) 626-9900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Washington State University Elson S Floyd College of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61501458 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Washington | Current | Accepting new patients | |
| Providence Health & Services - Wa | Past | Accepting new patients |
Locations
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181
624 E Front Ave
Spokane, WA 99202
Phone (509) 626-9900
Organizations & group practices 3
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.
-
dba Providence Medical Group
- Pulmonary Disease Physician
- Spokane, WA
- NPI 1194099390
Internal Medicine
-
dba PMG PHC Providence Express Care
- General Practice Physician
- Spokane, WA
- NPI 1306391446
-
dba Prov Scred Hrt Med Ctr & Chlds Hos
- General Acute Care Hospital
- Spokane, WA
- NPI 1144471715
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Prov Scred Hrt Med Ctr & Chlds Hos
- General Acute Care Hospital
- Spokane, WA
- NPI 1144471715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1184202541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "509-890-0931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 8TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042307",
"telephone_number": "509-474-3260"
}
],
"practiceLocations": [
{
"address_1": "624 E Front Ave",
"address_purpose": "LOCATION",
"city": "Spokane",
"state": "WA",
"postal_code": "992022139",
"country_code": "US",
"telephone_number": "509-626-9900",
"fax_number": "509-626-9917",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOSEPHSEN",
"first_name": "SAMUEL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-29",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD61501458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.