Prince D Samuel, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

01057972A Issued in IN

Practice address

4221 Washington Ave
Evansville, IN 47714-0675

Phone

(812) 476-6500

Fax

(812) 476-6507

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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.

• Hayden Vision LLC

  • Ophthalmology Physician
  • Evansville, IN
  • NPI 1982910253

  IN

  Medicare reassignment NPD
• American Eye Associates, LLC

  • Ophthalmology Physician
  • Evansville, IN
  • NPI 1477541449
  NPD (past)
• Charles a. Garcia, M.D.,P.a.

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1043236938

  Retina Specialist

  NPD (past)
• Garcia & Associates, East Houston P.a.

  • Specialist
  • Houston, TX
  • NPI 1306862230
  NPD (past)
• Greater Dallas Healthcare Enterprises

  • Obstetrics & Gynecology Physician
  • Dallas, TX
  • NPI 1255542122
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1295730299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140675",
            "telephone_number": "812-476-6500",
            "fax_number": "812-476-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140675",
            "telephone_number": "812-476-6500",
            "fax_number": "812-476-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "PRINCE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IN",
            "license": "01057972A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200454280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sam'S Club Optical
• Bill J Samm, MD
• Steven F. Sampson, O.D.
• Sams East Inc
• Angela L Sams, NP
• Jaya Subha Sanapati, MD
• Mahendra R. Sanapati, M.D.
• David Scot Sandage, PMHNP-BC
• Jamie Michelle Sander, RN, BSN
• Sanders Medical, LLC

• All providers in Evansville, IN
• Retina Specialist (Ophthalmology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.