India Samuels

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

253611 Issued in AZ

Practice address

460 N Mesa Dr
Mesa, AZ 85201-5973

Phone

(877) 931-9142

NPI assigned

Oct 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Recover Together IncGroup PAC ID 7810247533, 141 clinicians

Journey of Hope Healing Center LLCGroup PAC ID 0547626855, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: india.samuelspmhnp.p1@direct.cbridges.nextgenshare.com

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.

• Journey of Hope Healing Center LLC

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1225754849

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD Authorized official
• Recover Together, LLC

  • Adult Mental Health Clinic/Center
  • Lawrenceburg, IN
  • NPI 1891102497
  Medicare reassignment Care Compare group
• Aims, LLC

  • Psychiatry Physician
  • Bremen, IN
  • NPI 1376072785
  Medicare reassignment NPD

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1407283294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 S HIGLEY RD # 104-125",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964795",
            "telephone_number": "480-442-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MESA DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852015973",
            "telephone_number": "877-931-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "INDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-11",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28170338A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "253611",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180647",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "253611",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71004709A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonny Sampedro, DC
• Ronald C Sampson, MD
• Samuel Day
• Samuel Soesbe, O.D., P.C.
• Shane Samuel
• Delaney Samuelson
• San Tan Behavioral Health SVCS
• San Tan Cardiovascular Center LLC
• San Tan Internal Medicine, PLLC
• San Tan Mobile Diagnostics LLC

• Psychiatric/Mental Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.