Individual provider Active NPI

Anna Samolkin, DPM

  • Podiatrist
  • Livingston, NJ
National Provider Identifier
1326244518
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N006360-1 Issued in NY
Practice address
12 Countryside Dr
Livingston, NJ 07039-2002
Phone
(973) 597-0230
NPI assigned
Jun 25, 2007
Last updated
Jun 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N006360-1 NY Primary

Addresses

Primary practice location

12 Countryside Dr
Livingston, NJ 07039-2002

Mailing address

12 Countryside Dr
Livingston, NJ 07039-2002
Phone (973) 597-0230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101130001053 NY Practitioner - Podiatry 3072709260 Practice locations: Brooklyn, NY
I20110205000017 NJ Practitioner - Podiatry 3072709260 Practice locations: Union City, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2951 Ocean Ave
Suite Aa
Brooklyn, NY 11235-3263
Phone (718) 934-7264

322 38TH St
Union City, NJ 07087-5283
Phone (201) 865-3400

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11
Removal of skin lesions30
Removal of nail tissue883
Removal or shaving of skin growth594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N006360-1NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Beach Int Med PC CurrentSince May 25, 2011 Accepting new patients
Ab Medical Care PLLC Past Accepting new patients
Osvaldo Cortina MD PC PastSince Sep 2, 2004 Accepting new patients
Karat Liberty Medical Care PC Past Accepting new patients
Petrychenko Physician PC Past Accepting new patients
Psychological Health Care of Ny Past Accepting new patients

Locations

133 W End Ave
Brooklyn, NY 11235
Phone (718) 743-5616

133A W End Ave
Brooklyn, NY 11235
Phone (718) 743-5616

Organizations & group practices 6

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1326244518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 COUNTRYSIDE DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392002",
            "telephone_number": "973-597-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 COUNTRYSIDE DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392002",
            "telephone_number": "973-597-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOLKIN",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N006360-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.