Individual provider Active NPI

Samuel Saylor Samsel III, LSW

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1356660310
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SL05543900 Issued in NJ
Practice address
534 Lippincott Dr Ste B
Marlton, NJ 08053-4805
Phone
(856) 355-7144
Fax
(856) 355-7143
NPI assigned
May 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL05543900 NJ
Clinical Social Worker 1041C0700X 44SL05543900 NJ Primary

Addresses

Primary practice location

534 Lippincott Dr Ste B
Marlton, NJ 08053-4805

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-7144

Other practice location 1

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 488-6789 ext. 2

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssamuel279101@directvirtua.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506004033 NJ Practitioner - Clinical Social Worker 8921448069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Rutgers New Jersey Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

534 Lippincott Dr
Marlton, NJ 08053-4805
Phone (856) 355-7120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL05543900NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jul 1, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 1, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince May 7, 2024 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

534 Lippincott Dr
Ste B
Marlton, NJ 08053
Phone (856) 355-7144

534 Lippincott Dr
Marlton, NJ 08053
Phone (856) 355-7146

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

Interoperability endpoints

  • Direct secure messaging: ssamuel279101@directvirtua.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1356660310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-7144",
            "fax_number": "856-355-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 LIPPINCOTT DR STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534805",
            "telephone_number": "856-355-7144",
            "fax_number": "856-355-7143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Chapel Ave W",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022048",
            "country_code": "US",
            "telephone_number": "856-488-6789 x2",
            "fax_number": "856-488-6625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSEL",
        "first_name": "SAMUEL",
        "middle_name": "SAYLOR",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05543900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL05543900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssamuel279101@directvirtua.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "534 Lippincott Dr Ste B",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.