Individual provider Active NPI

Samuel George Wittekind, M.D.

  • Pediatric Cardiology Physician
  • Cincinnati, OH
National Provider Identifier
1316262710
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
MED-PHYS-LIC-113820 Issued in MT
Practice address
3333 Burnet Ave.
ML 2003
Cincinnati, OH 45229
Phone
(513) 636-4432
Fax
(513) 636-3952
NPI assigned
Mar 30, 2010
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 57.025498 OH
Pediatrics Physician 208000000X 271030-1 NY
Pediatrics Physician 208000000X 60156855 WA
Pediatric Cardiology Physician 2080P0202X 35.134313 OH
Pediatric Cardiology Physician 2080P0202X MED-PHYS-LIC-113820 MT Primary

Addresses

Primary practice location

3333 Burnet Ave.
ML 2003
Cincinnati, OH 45229

Mailing address

3333 Burnet Ave.
ML 2003
Cincinnati, OH 45229-3026
Phone (513) 636-4432

Other practice location 1

937 Highland Blvd Ste 5320
Bozeman, MT 59715-6916
Phone (406) 414-4900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swittekind17314697@direct.sanfordhealth.org Direct Bozeman Health Deaconess Hospital

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220802001665 MT Practitioner - Pediatric Medicine 7911133640 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
271030-1NYMDPediatrics Physician
60156855WAMDPediatrics Physician
MED-PHYS-LIC-113820MTMDPediatric Cardiology Physician
57.025498OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children's Hospital CurrentSince Jul 2, 2022 Accepting new patients
Bozeman Health Deaconess Hospital CurrentSince Aug 1, 2022 Accepting new patients
Seattle Childrens Hospital CurrentSince Jul 2, 2022 Accepting new patients
Bozeman Health Deaconess Hospital CurrentSince Aug 1, 2022 Accepting new patients
Bozeman Health Deaconess Hospital Pediatrics Current Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients

Locations

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

925 Highland Blvd
Ste 1220
Bozeman, MT 59715
Phone (406) 414-3780

937 Highland Blvd
Ste 5320
Bozeman, MT 59715
Phone (406) 414-4570

2510 Bobcat Way
Great Falls, MT 59405
Phone (206) 771-3223

Interoperability endpoints

  • Direct secure messaging: swittekind17314697@direct.sanfordhealth.org
  • Direct secure messaging: swittekind178336@direct.seattlechildrens.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1316262710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE.",
            "address_2": "ML 2003",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4432",
            "fax_number": "513-636-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE.",
            "address_2": "ML 2003",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-4432",
            "fax_number": "513-636-3952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "937 Highland Blvd Ste 5320",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597156916",
            "country_code": "US",
            "telephone_number": "406-414-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTEKIND",
        "first_name": "SAMUEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.025498",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "271030-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60156855",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.134313",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-113820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swittekind17314697@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Deaconess Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "937 Highland Blvd Ste 5320",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597156916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.