Individual provider Active NPI

David Samenuk, MD

  • Cardiovascular Disease Physician
  • Medford, MA
National Provider Identifier
1376517532
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
155126 Issued in MA
Practice address
137 Main St
Medford, MA 02155
Phone
(781) 395-4909
Fax
(781) 395-5081
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 155126 MA Primary

Addresses

Primary practice location

137 Main St
Medford, MA 02155

Mailing address

137 Main St
Medford, MA 02155
Phone (781) 395-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101222000125 MA Practitioner - Cardiovascular Disease (Cardiology) 2365630043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

127 Main St
Medford, MA 02155-4522
Phone (781) 395-4909

137 Main St
Medford, MA 02155-4522
Phone (781) 395-4761

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

Hospital & facility affiliations

  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155126MAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc Cardiovascular Disease CurrentSince Jan 1, 2016 Accepting new patients
Hallmark Health Medical Associates Inc Past Accepting new patients
Mass General Brigham Community Physicians Inc. Cardiovascular Disease Past Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

127 Main St
Medford, MA 02155
Phone (781) 395-4909

170 Governors Ave
Fl 2
Medford, MA 02155
Phone (781) 395-4909

137 Main St
Medford, MA 02155
Phone (781) 395-4761

Interoperability endpoints

  • Direct secure messaging: samenuk.david.mcard@direct.partners.masshiway.net

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.

Hospital & facility affiliations 5

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1376517532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-395-4909",
            "fax_number": "781-395-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-395-4909",
            "fax_number": "781-395-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMENUK",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "155126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.