NPIMap

Individual provider Active NPI

Xavier Jimenez Samayoa, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1467870931
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
312823 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(646) 962-2746
NPI assigned
Apr 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD462190 PA
Student in an Organized Health Care Education/Training Program 390200000X
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 312823 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

525 E 68TH St
New York, NY 10065-4870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20240812001273 UT Practitioner - Critical Care (Intensivists) 7214201581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

325 8TH Ave
Salt Lake City, UT 84143-0001
Phone (801) 408-3617

5171 S Cottonwood St
Suite 350
Murray, UT 84107-5733
Phone (801) 507-9390

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

8 TH Ave and C St
Salt Lake City, UT 84143-0001
Phone (801) 408-1100

Hospital & facility affiliations

  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
  • Park City Hospital Hospital, Park City, UT, CCN 460057
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD462190PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince May 11, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince May 11, 2024 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5171 S Cottonwood St
Ste 350
Salt Lake City, UT 84107
Phone (801) 507-2831

Organizations & group practices 3

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 6

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1467870931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "646-962-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ SAMAYOA",
        "first_name": "XAVIER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD462190",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "312823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.