Active NPI
Michael Samuel, M.D.
- Diagnostic Radiology Physician
- Bangor, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD27155
- Practice address
- 489 State St
Bangor, ME 04401-6616 - Phone
- (207) 973-7000
- NPI assigned
- Apr 1, 2016
- Last updated
- Aug 31, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD27155 | ME | Primary |
Addresses
Primary practice location
489 State St
Bangor, ME 04401-6616
Mailing address
324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (072) 482-7800
Other practice location 1
111 E 210th St
Bronx, NY 10467-2401
Phone (718) 696-2583
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275996779 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
324 Gannett Dr
Suite 200
South Portland, ME 04106-3263
5570 Longley LN
Suite B
Reno, NV 89511-1825
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD27155 | ME | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Healthcare Partners, P.a. | Current | Accepting new patients | |
| Spectrum Healthcare Partners, PA | Diagnostic Radiology | Current | Accepting new patients |
| Insight-Premier Health LLC | Diagnostic Radiology | Current | Accepting new patients |
| Shields Pet/CT at CMMC, LLC | Current | Accepting new patients |
Locations
489 State St
Bangor, ME 04401
Phone (207) 973-8837
300 Main St
Lewiston, ME 04240
Phone (207) 795-2400
324 Gannett Dr
Ste 200
South Portland, ME 04106
Phone (207) 482-7861
Organizations & group practices 4
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.
-
dba Spectrum Radiology North
- Diagnostic Radiology Physician
- Bangor, ME
- NPI 1710993159
-
dba RAYUS Radiology Bangor
- Diagnostic Radiology Physician
- Bangor, ME
- NPI 1922655562
-
- Mobile Radiology Clinic/Center
- Lewiston, ME
- NPI 1982153052
-
dba Spectrum Pathology
- Anatomic Pathology & Clinical Pathology Physician
- Portland, ME
- NPI 1386757607
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bangor, ME
- NPI 1790789147
-
dba Northern Light Maine Coast Hospital
- General Acute Care Hospital
- Ellsworth, ME
- NPI 1740249739
-
- General Acute Care Hospital
- Bangor, ME
- NPI 1154321545
-
dba Northern Light Blue Hill Hospital
- Critical Access Hospital
- Blue Hill, ME
- NPI 1023057809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1275996779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 GANNETT DR STE 200",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041063266",
"telephone_number": "072-482-7800",
"fax_number": "207-482-7898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "489 STATE ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044016616",
"telephone_number": "207-973-7000"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-696-2583",
"fax_number": "718-881-5074",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAMUEL",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-01",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ME",
"license": "MD27155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1275996779",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.