Individual provider Active NPI

Samantha Alonso

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1255785499
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
315328 Issued in NY
Practice address
318 Knickerbocker Ave
Brooklyn, NY 11237-3888
Phone
(718) 765-6056
Fax
(347) 803-1874
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 82275 GA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 315328 NY Primary

Addresses

Primary practice location

318 Knickerbocker Ave
Brooklyn, NY 11237-3888

Mailing address

318 Knickerbocker Ave
Brooklyn, NY 11237-3888
Phone (718) 765-6056

Other practice location 1

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000 ext. 57141

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220804002182 NY Practitioner - Internal Medicine 5597058693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82275GAMDInternal Medicine Physician
315328NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 8, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: salonso2279714@nychhc.direct-ci.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1255785499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373888",
            "telephone_number": "718-765-6056",
            "fax_number": "347-803-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373888",
            "telephone_number": "718-765-6056",
            "fax_number": "347-803-1874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033031",
            "country_code": "US",
            "telephone_number": "404-616-1000 x57141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "82275",
            "primary": false
        },
        {
            "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": "NY",
            "license": "315328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.