Active NPI
Samuel J Essma, MD
- Diagnostic Radiology Physician
- Alton, IL
National Provider Identifier
1457361065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036084761
- Practice address
- 1 Memorial Dr
Alton Memorial Hospital
Alton, IL 62002-6722 - Phone
- (618) 463-7415
- Fax
- (314) 821-2180
- NPI assigned
- Aug 8, 2006
- Last updated
- Apr 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036084761 | IL | Primary |
Addresses
Primary practice location
1 Memorial Dr
Alton Memorial Hospital
Alton, IL 62002-6722
Mailing address
55 Westport Plaza Drive
Suite 300
St Louis, MO 63146
Phone (314) 548-4772
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1390 | Other | MO BLUE | |
| 431725842MID | Other | MERCY | |
| 225826 | Other | HLINK | |
| 2781 | Other | GHP | |
| 46033 | Other | HCARE USA | |
| 300066977 | Other | RR MEDICARE | |
| 300066982 | Other | RR MEDICARE | |
| F42701 | Other | GATEWAY | |
| 136331 | Other | BLUE CHOICE | |
| 1600001 | Other | PH PLAN | |
| 300066972 | Other | RR MEDICARE | |
| 0006021895 | Other | IL BLUE | |
| 0360847611 | Medicaid | IL | |
| 300066 | Other | HLT PART |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- sessma135193@direct.carenet.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1457361065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WESTPORT PLAZA DRIVE",
"address_2": "SUITE 300",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63146",
"telephone_number": "314-548-4772",
"fax_number": "314-548-4748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEMORIAL DR",
"address_2": "ALTON MEMORIAL HOSPITAL",
"city": "ALTON",
"state": "IL",
"postal_code": "620026722",
"telephone_number": "618-463-7415",
"fax_number": "314-821-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESSMA",
"first_name": "SAMUEL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036084761",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO BLUE",
"identifier": "1390",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "431725842MID",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HLINK",
"identifier": "225826",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "2781",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCARE USA",
"identifier": "46033",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300066977",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300066982",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "F42701",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "136331",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PH PLAN",
"identifier": "1600001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300066972",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL BLUE",
"identifier": "0006021895",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360847611",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HLT PART",
"identifier": "300066",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.