Individual provider Active NPI

Samantha Maizer, RN

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1417565680
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
789400 Issued in NY
Practice address
1477 Hylan Blvd
Staten Island, NY 10305-1999
Phone
(718) 979-6900
Fax
(718) 979-6940
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 789400 NY Primary

Addresses

Primary practice location

1477 Hylan Blvd
Staten Island, NY 10305-1999

Mailing address

52 Raritan Ave
Staten Island, NY 10304-4012
Phone (347) 372-1568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
789400NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Homemakers of Staten Island, Inc. CurrentSince Aug 11, 2024 Accepting new patients

Locations

1477 Hylan Blvd
Staten Island, NY 10305
Phone (718) 979-9600

Organizations & group practices 1

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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1417565680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 RARITAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044012",
            "telephone_number": "347-372-1568",
            "fax_number": "718-979-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051999",
            "telephone_number": "718-979-6900",
            "fax_number": "718-979-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIZER",
        "first_name": "SAMANTHA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "789400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.