Jermale Sam, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

Q5557 Issued in TX

Practice address

1500 Citywest Blvd
Ste. 300
Houston, TX 77042-2300

Phone

(713) 620-4000

Fax

(713) 458-4229

NPI assigned

Jul 27, 2010

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 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Baylor College of Medicine

  • Ph.D. Medical Genetics
  • Houston, TX
  • NPI 1881026664

  Anesthesiology

  Medicare reassignment NPD
• Kelsey-Seybold Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255
  Medicare reassignment NPD
• Baylor College of Medicine

  • Orthopaedic Surgery Physician
  • Sugar Land, TX
  • NPI 1700683844
  NPD

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1295049799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD",
            "address_2": "STE. 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422300",
            "telephone_number": "713-620-4000",
            "fax_number": "713-458-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Campbell Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770557407",
            "country_code": "US",
            "telephone_number": "713-442-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "JERMALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q5557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349593901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01580991",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8FN447",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sam Houston Park Diagnostics, LLC
• Aji Sam, ACNPC-AG (NP)
• Annamma Varghese Sam, RN, WHNP
• Deborah Sam
• Dhanisha Sam
• Kathy Sam, M.D.
• Kenny Sam, D.O.
• Matthew Sam, M.D.
• Rebecca McDonald Sam, RN
• Sachu Sam, PMHNP-BC

• Anesthesiology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.