NPIMap

Individual provider Active NPI

Susamma Samuel

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1326690868
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP140870 Issued in TX
Practice address
221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312
Phone
(214) 960-5681
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP140870 TX
Acute Care Nurse Practitioner 363LA2100X AP140870 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312

Mailing address

PO Box 845347
Dallas, TX 75284-7208

Other practice location 1

1228 Muscogee Trl
Carrollton, TX 75010-1164
Phone (214) 223-2359

Other practice location 2

5323 Harry Hines Blvd
Dallas, TX 75390
Phone (214) 223-2359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191119000958 TX Practitioner - Nurse Practitioner 1951733658 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015
  • Methodist Southlake Medical Center Hospital, Southlake, TX, CCN 670132
  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723
  • Texas Health Harris Methodist Hurst-Euless-Bedford Hospital, Bedford, TX, CCN 450639

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Nurse Practitioner CurrentSince Jan 18, 2025 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Dallas County Hospital District Nurse Practitioner CurrentSince Jan 18, 2025 Accepting new patients
Healthtexas Provider Network CurrentSince Jun 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 21, 2019 Accepting new patients
Dallas Pulmonary & Critical Care PA Acute Care CurrentSince Oct 13, 2021 Accepting new patients
Dallas County Hospital District Nurse Practitioner Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 21, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Jun 1, 2021 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

1250 8th Ave
Ste 200
Fort Worth, TX 76104
Phone (817) 912-8020

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 10

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 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1326690868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD STE 525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082312",
            "telephone_number": "214-960-5681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1228 Muscogee Trl",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "750101164",
            "country_code": "US",
            "telephone_number": "214-223-2359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75390",
            "country_code": "US",
            "telephone_number": "214-223-2359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SUSAMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP140870",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP140870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.