Individual provider Active NPI

Samaresh Dasgupta, D.O.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1265638787
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB08949800 Issued in NJ
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-6336
Fax
(215) 456-6601
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS014627 PA
Student in an Organized Health Care Education/Training Program 390200000X OT012210 PA
Emergency Medicine Physician 207P00000X 25MB08949800 NJ Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

929 Cox Rd
Moorestown, NJ 08057-3937

Other identifiers 1

IdentifierTypeStateIssuer
0269948MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110720000650 NJ Practitioner - Emergency Medicine 4789879917 Reassigns benefits to 3 organizations
I20260521002862 DE Practitioner - Emergency Medicine 4789879917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Jersey Hyperbaric Medicine LLCGroup PAC ID 9436427499, 28 clinicians
Bayhealth Emergency Physicians LLCGroup PAC ID 7719240696, 80 clinicians

Practice addresses (Care Compare)

501 Front St
Elmer, NJ 08318-2101
Phone (856) 363-1000

640 S State St
Bayhealth Emergency Physicians KGH
Dover, DE 19901-3530
Phone (302) 744-6156

Hospital & facility affiliations

  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032
  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012210PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
South Jersey Health System Emergency Physician Services P a Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients
Zomi Med, LLC CurrentSince Jul 5, 2020 Accepting new patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Jun 1, 2014 Accepting new patients
South Jersey Hyperbaric Medicine LLC CurrentSince Apr 26, 2017 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Organizations & group practices 7

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 4

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1265638787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 COX RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-6336",
            "fax_number": "215-456-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASGUPTA",
        "first_name": "SAMARESH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS014627",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT012210",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB08949800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0269948",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.