NPIMap

Individual provider Active NPI

Samantha Greene, PA-C

  • Physician Assistant
  • Stamford, CT
National Provider Identifier
1467112359
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Blachley Rd
Stamford, CT 06902-0002
Phone
(203) 705-0766
NPI assigned
Dec 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1 Blachley Rd
Stamford, CT 06902-0002

Mailing address

1 Blachley Rd
Stamford, CT 06902-0002

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sgreene206369@direct.hss.edu Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324000086 CT Practitioner - Physician Assistant 2860887163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Blachley Rd
Stamford, CT 06902-0002
Phone (212) 774-7598

2080 Whitney Ave
Suite 280
Hamden, CT 06518-3603
Phone (203) 288-2555

Hospital & facility affiliations

  • Stamford Hospital Hospital, Stamford, CT, CCN 070006
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Feb 14, 2022 Accepting new patients
New York Society for the Relief of Ruptured and Crippled Maintain Past Accepting new patients

Locations

1 Blachley Rd
Stamford, CT 06902
Phone (203) 705-0750

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

276 Post Rd W
Westport, CT 06880
Phone (203) 391-2270

535 E 70th St
New York, NY 10021

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • Direct secure messaging: sgreene24500@stamfordhealth.direct-ci.com
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 2

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 11

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": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1467112359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020002",
            "telephone_number": "203-705-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2022-10-12",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgreene206369@direct.hss.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.