Pauline M. Samuels, M.D., PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD956958L Issued in PA

Legal business name

PAULINE M. SAMUELS, M.D., PC

Practice address

3712 Garrett Rd
Drexel Hill, PA 19026-3505

Phone

(610) 394-6666

Fax

(610) 394-6667

NPI assigned

Jul 14, 2006

Organization subpart

No

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

Authorized official

Name

Pauline M Samuels, M.D.NPI 1033132709

Title

President

Phone

(610) 394-6666

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pauline M Samuels, M.D.

  • Internal Medicine Physician
  • Broomall, PA
  • NPI 1033132709
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1356367254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 GARRETT RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263505",
            "telephone_number": "610-394-6666",
            "fax_number": "610-394-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 GARRETT RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263505",
            "telephone_number": "610-394-6666",
            "fax_number": "610-394-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULINE M. SAMUELS, M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-394-6666",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD956958L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0561",
            "identifier": "AETNA",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2147326001",
            "identifier": "KEYSTONE",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016036540005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERHEALTH",
            "identifier": "8240",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stephanie J Pearson, MD
• Pennsylvania CVS Pharmacy LLC
• Pennsylvania CVS Pharmacy, L.L.C.
• Barbara Perin
• Kaitlin Perni

• Internal Medicine Physician in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.