Individual provider Active NPI

Sam Laggui Samonte Jr., APN

  • Adult Health Nurse Practitioner
  • Perth Amboy, NJ
National Provider Identifier
1316187594
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00187100 Issued in NJ
Practice address
275 Hobart St
Perth Amboy, NJ 08861-3396
Phone
(732) 376-9333
NPI assigned
Feb 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00187100 NJ Primary

Addresses

Primary practice location

275 Hobart St
Perth Amboy, NJ 08861-3396

Mailing address

73 Willard Avenue
Bloomfield, NJ 07003
Phone (201) 486-9310

Other names 1

  • Sam Laggui Samonte Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20090715000581 NJ Practitioner - Nurse Practitioner 1052463429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00187100NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Medical Center, Inc CurrentSince Nov 15, 2021 Accepting new patients
Central Jersey Medical Center, Inc. CurrentSince Nov 15, 2021 Accepting new patients
Wound Care Specialist of New Jersey Adult Health Past Accepting new patients

Locations

80 Johnson Ave
Newark, NJ 07108
Phone (973) 623-8592

275 Hobart St
Perth Amboy, NJ 08861
Phone (732) 376-6635

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1316187594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 WILLARD AVENUE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "07003",
            "telephone_number": "201-486-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOBART ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613396",
            "telephone_number": "732-376-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMONTE",
        "first_name": "SAM",
        "middle_name": "LAGGUI",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-27",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00187100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "SAMONTE",
            "middle_name": "LAGGUI",
            "credential": "APN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.