Organization Active NPI

Samir Macwan, M.D., Inc.

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Rancho Mirage, CA
National Provider Identifier
1184457970
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X
Legal business name
SAMIR MACWAN, M.D., INC.
Practice address
72780 Country Club Dr Ste A104
Rancho Mirage, CA 92270-4150
Phone
(760) 895-0639
NPI assigned
Aug 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Samir Macwan, MDNPI 1265558753
Title
Owner
Phone
(760) 895-0639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0008X Primary

Addresses

Primary practice location

72780 Country Club Dr Ste A104
Rancho Mirage, CA 92270-4150

Mailing address

72780 Country Club Dr Ste A104
Rancho Mirage, CA 92270-4150
Phone (760) 895-0639

Other practice location 1

1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872
Phone (760) 895-0639

Other practice location 2

35400 Bob Hope Dr Ste 213
Rancho Mirage, CA 92270-1774
Phone (760) 895-0639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241031001916 CA Part B Supplier - Clinic/Group Practice 4880127620 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Mirage, CA

National Provider Directory

National Provider Directory

Locations

35400 Bob Hope Dr
Ste 213
Rancho Mirage, CA 92270
Phone (442) 256-6650

35900 Bob Hope Dr
Ste 210
Rancho Mirage, CA 92270
Phone (760) 531-4068

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1184457970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR STE A104",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704150",
            "telephone_number": "760-895-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72780 COUNTRY CLUB DR STE A104",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704150",
            "telephone_number": "760-895-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N Indian Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624872",
            "country_code": "US",
            "telephone_number": "760-895-0639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35400 Bob Hope Dr Ste 213",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922701774",
            "country_code": "US",
            "telephone_number": "760-895-0639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAMIR MACWAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "MACWAN",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-895-0639",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.