Individual provider Active NPI

Kenia Samuel, M.D.

  • Internal Medicine Physician
  • Marietta, OH
National Provider Identifier
1427465053
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
299344 Issued in NY
Practice address
401 Matthew St
Marietta, OH 45750-1635
Phone
(740) 374-7700
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35131408 OH
Internal Medicine Physician 207R00000X 299344 NY Primary

Addresses

Primary practice location

401 Matthew St
Marietta, OH 45750-1635

Mailing address

401 Matthew St.
Marietta, OH 45750
Phone (740) 374-7700

Other practice location 1

1106 Colegate Dr
Marietta, OH 45750-1323
Phone (740) 374-7700

Other practice location 2

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-0100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hospital.provider@mmhs.medicity.net
Direct Messaging Address hospital.provider@mmhs.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170619001776 OH Practitioner - Hospitalist 2163790080 Reassigns benefits to 2 organizations
I20200616002142 NY Practitioner - Internal Medicine 2163790080 Reassigns benefits to 2 organizations
I20260127001488 CA Practitioner - Internal Medicine 2163790080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians
Rocket Doctor Practice Group PCGroup PAC ID 3577007764, 9 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3058

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1623

881 Dover Dr
Suite 200
Newport Beach, CA 92663-6922
Phone (831) 777-4283

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299344NYMDInternal Medicine Physician
35131408OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients
Marietta Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients
Rocket Doctor Practice Group, P.C. Internal Medicine CurrentSince Oct 8, 2025 Accepting new patients

Locations

20311 SW Acacia St
Ste 140
Newport Beach, CA 92660
Phone (831) 777-4283

881 Dover Dr
Ste 200
Newport Beach, CA 92663

2219 Main St
Santa Monica, CA 90405
Phone (310) 800-1630

447 Broadway
Fl 2
New York, NY 10013
Phone (347) 807-3288

1106 Colegate Dr
Marietta, OH 45750
Phone (740) 374-7700

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

701 Hildreth Ln
Marietta, OH 45750
Phone (740) 371-7194

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ksamuel66926@northwell.direct-ci.com

Organizations & group practices 5

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 2

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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1427465053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST.",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-374-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-374-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 Colegate Dr",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501323",
            "country_code": "US",
            "telephone_number": "740-374-7700",
            "fax_number": "740-374-7701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-562-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "KENIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35131408",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "299344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hospital.provider@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "1106 Colegate Dr",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hospital.provider@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "401 Matthew St",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.