John C Samuel, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

047046 Issued in CT

Practice address

333 Cedar Street Lmp4085
Department of Pediatrics
New Haven, CT 06520-8064

Phone

(203) 785-6668

Fax

(203) 785-6925

NPI assigned

Sep 7, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jsamuel8208@direct.ynhh.org

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.

• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)
• Saint Raphael Healthcare System Affiliated Physicians Inc

  • Neurology Physician
  • New Haven, CT
  • NPI 1063744001

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1205939865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR STREET-LMP4085",
            "address_2": "P.O.BOX 208064 DEPARTMENT OF PEDIATRICS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208064",
            "telephone_number": "203-785-6668",
            "fax_number": "203-785-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CEDAR STREET LMP4085",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208064",
            "telephone_number": "203-785-6668",
            "fax_number": "203-785-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "047046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00575388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc D Samsky, M.D.
• Henry B Samson, OD
• Leah Samson, MD
• Lydia Anne Samson, BSN, RN
• Emily Elizabeth Samuel, LPC
• Shayla Samuel
• Elizabeth Anne Samuels, M.D., MPH
• Keri-Ann Samuels
• Stephanie Lynn Samuels, M.D.
• Sam Samuelson

• Pediatrics Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.