Andrey Samodumov, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

R7314 Issued in TX

Practice address

6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524

Phone

(972) 715-5000

Fax

(972) 715-9976

NPI assigned

Jun 21, 2014

Last updated

Mar 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Anesthesiology

Education

University of Texas Medical School at San Antonio, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Ips LLCGroup PAC ID 9638356801, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Ips LLC

  • Pulmonary Disease Physician
  • San Antonio, TX
  • NPI 1629368535

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Tejas Anesthesia PLLC

  • Anesthesiology Physician
  • League City, TX
  • NPI 1659383305

  Single Specialty

  Medicare reassignment NPD
• Tejas Anesthesia PLLC

  • Anesthesiology Physician
  • San Antonio, TX
  • NPI 1659027910
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  dba Methodist Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1124074273
  Care Compare affiliation
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  dba Metropolitan Methodist Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1689627655
  Care Compare affiliation
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  dba Methodist Specialty and Transplant Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1952348021
  Care Compare affiliation

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1447665104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMODUMOV",
        "first_name": "ANDREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-21",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R7314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas M Sammer, MD
• Eric Sammons, CRNA
• Alisha Ali Samnani
• Hussain Samnani, CRNA
• Yoni Samocha, M.D.
• Milena Sampaio, MD
• Debbie Lynn Sampath, P.T.
• Karthik Sampath, M.D.
• Jessica Brooke Sample, RN, CPNP-PC
• Koby Sample, STUDENT

• Anesthesiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.