Individual provider Active NPI

Samir I Hamati, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Spring Lake, MI
National Provider Identifier
1225050552
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
License
4301049458 Issued in MI
Practice address
17208 Vanwagoner Rd
Spring Lake, MI 49456
Phone
(231) 724-7840
NPI assigned
Jul 24, 2006
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301049458 MI
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X 4301049458 MI Primary

Addresses

Primary practice location

17208 Vanwagoner Rd
Spring Lake, MI 49456

Mailing address

17208 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone (231) 724-7840

Other practice location 1

6401 Prairie St
Ste 2700
Norton Shores, MI 49444-7841
Phone (231) 724-7840

Other identifiers 1

IdentifierTypeStateIssuer
1689757MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050429000786 MI Practitioner - Obstetrics/Gynecology 6709825524 Practice locations: Spring Lake, MI

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301049458MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Levi J Pulver DC PLLC PastSince Aug 7, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1225050552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17208 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "231-724-7840",
            "fax_number": "231-724-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17208 VANWAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "49456",
            "telephone_number": "231-724-7840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 PRAIRIE ST",
            "address_2": "STE 2700",
            "address_purpose": "LOCATION",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447841",
            "country_code": "US",
            "telephone_number": "231-724-7840",
            "fax_number": "231-724-7841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMATI",
        "first_name": "SAMIR",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301049458",
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MI",
            "license": "4301049458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689757",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, MI

Sources for this page

Verify at the official NPI Registry.