Mohamed Elsamra, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042987 Issued in CT

Practice address

179 Post Rd W
Westport, CT 06880-4602

Phone

(203) 450-4882

NPI assigned

Aug 16, 2006

Last updated

Aug 9, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Psychiatry

Education

Other, 1994

Medicare assignment

May accept Medicare assignment

Group practices

Meditox Care, LLCGroup PAC ID 9830535723, 5 clinicians

Practice addresses (Care Compare)

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.

• Meditox Care, LLC

  dba Elevate Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westport, CT
  • NPI 1730623737

  Psychiatry

  Medicare reassignment Care Compare group NPD Authorized official
• Meditox Care, LLC

  • Psychiatric Residential Treatment Facility
  • Clinton, CT
  • NPI 1003788233
  Authorized official Same address or phone
• Meditox Care, LLC

  dba Elevate Health and Wellness

  • Substance Abuse Rehabilitation Facility
  • Westport, CT
  • NPI 1629703384
  Authorized official Same address or phone
• Meditox Care, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westport, CT
  • NPI 1942119177
  Authorized official Same address or phone
• Eastern Connecticut Medical Professionals Foundation, Inc

  dba Eastern Orthopeadics and Sports Medicine, PC

  • Specialist
  • South Windsor, CT
  • NPI 1497864516
  NPD (past)
• Positive Directions - the Center for Prevention and Counseling Inc

  • Community/Behavioral Health Agency
  • Westport, CT
  • NPI 1629217286
  NPD (past)
• Positive Directions - the Center for Prevention and Counseling, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westport, CT
  • NPI 1629126875
  NPD (past)
• The Connection Inc.

  • Adult Mental Health Clinic/Center
  • New Haven, CT
  • NPI 1992823538
  NPD (past)
• Urologic Associates, PC

  • Urology Physician
  • New London, CT
  • NPI 1740362730
  NPD (past)
• Centrus Premier Home Care Inc

  • Home Health Agency
  • Plymouth, MA
  • NPI 1194711226
  NPD (past)
• Prescott Health Care

  • Psychiatry Physician
  • Worcester, MA
  • NPI 1477567451
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1457464406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804602",
            "telephone_number": "203-450-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804602",
            "telephone_number": "203-450-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSAMRA",
        "first_name": "MOHAMED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "227164",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "042987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arnona Eden Davidai, LCSW, PH.D
• Heather M Ehinger, LMFT
• Stephanie Gail Ehrman, PH.D.
• Joseph Eiffert, OD
• Wendy Spector Eisenberg, M.A., PH.D.
• Energetiv Care Services
• Margaret Enright
• Paul Epstein
• Richard Allen Epstein, DMD,FAGD
• Wendy Howard Epstein

• Psychiatry Physician in Westport, CT
• Providers in Westport, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.