Polina Moiseyevna Samoylova, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11404 Issued in AZ

Practice address

400 W Magee Rd
Tucson, AZ 85704-6438

Phone

(520) 638-5553

Fax

(520) 638-5543

NPI assigned

Jul 13, 2018

Sex

Female

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 AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pima Neurology IncGroup PAC ID 9436300506, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Pima Neurology Inc

  • Neurology Physician
  • Tucson, AZ
  • NPI 1174871917
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1295211159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MAGEE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045555",
            "telephone_number": "520-638-5553",
            "fax_number": "520-638-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAGEE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857046438",
            "telephone_number": "520-638-5553",
            "fax_number": "520-638-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOYLOVA",
        "first_name": "POLINA",
        "middle_name": "MOISEYEVNA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF NURSING",
            "identifier": "AP11404",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD",
            "identifier": "F06182317",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295211159",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Relph Sammons, PH.D.
• Margaret Catherine Sammons, MS SLP CF
• Rogelio Santamaria Samorano, MD
• Sarah Samoy, MD
• Valarie Samoy, DPM
• Linda H Sampliner, EDD
• Haley Elizabeth Sampsell, PA-C
• Adelene Sampson
• Rachel Sampson, M.A. CCC-SLP
• Tara Samra, MD

• Family Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.

Verify at the official NPI Registry.