Individual provider Active NPI

Camille Samujh, DO

  • Anesthesiology Physician
  • Puyallup, WA
National Provider Identifier
1326467846
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OP60853420 Issued in WA
Practice address
407 14TH Ave SE
Puyallup, WA 98372-3770
Phone
(253) 697-4000
NPI assigned
Apr 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X OP60853420 WA Primary

Addresses

Primary practice location

407 14TH Ave SE
Puyallup, WA 98372-3770

Mailing address

PO Box 35142
Seattle, WA 98124-5142

Other practice location 1

4802 10th avenue
Maimondes Medical Center
brooklyn, NY 11219
Phone (206) 383-8679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20181213002832 WA Practitioner - Anesthesiology 8729323019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rainier Anesthesia Associates PCGroup PAC ID 4284523499, 69 clinicians

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 848-6661

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Anesthesia Associates PC Anesthesiology CurrentSince Aug 22, 2018 Accepting new patients

Locations

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1326467846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35142",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723770",
            "telephone_number": "253-697-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 10th avenue",
            "address_2": "Maimondes Medical Center",
            "address_purpose": "LOCATION",
            "city": "brooklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "206-383-8679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUJH",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-11",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP60853420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.