Samuel Walters, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS8337 Issued in FL

Practice address

7451 103Rd St Ste 8
Jacksonville, FL 32210-6788

Phone

(904) 683-4968

Fax

(904) 902-1202

NPI assigned

Jan 25, 2006

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, NY2 enrollments

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 2

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pinnacle Home Care Home health agency, Ormond Beach, FL, CCN 108499

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.walters.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• City Medical of Upper East Side, PLLC

  dba CityMD Urgent Care

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1801277629
  Medicare reassignment Care Compare group
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Patrick Bunyi MD LLC

  • Clinic/Center
  • Jacksonville, FL
  • NPI 1598081945
  NPD
• City Medical of Upper East Side, PLLC

  dba Citymd

  • Multi-Specialty Clinic/Center
  • Huntington, NY
  • NPI 1043815848
  NPD (past)
• New York Community Hospital of Brooklyn, Inc.

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1205840055

  Family Medicine

  NPD (past)

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

• Pinnacle Home Care of the Villages, Inc.

  dba Pinnacle Home Care

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1134716970
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1336119817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 103RD ST STE 8",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106788",
            "telephone_number": "904-683-4968",
            "fax_number": "904-902-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "SAMUEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261008600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Walters
• Lashawnda Artrice Walters, M.H.C
• Lynda Elizabeth Walters, CRNA
• Nicole Marie Walters, APRN
• Samantha Darlene Walters, PA-C
• Walton Brueske Counseling Group PA
• Walton Medical Staffing, LLC
• Alonna Danay Walton
• Delvega Shantelle Walton
• Felisa Walton, RN

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.