Individual provider Active NPI

Samantha N Singh, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Bayonne, NJ
National Provider Identifier
1477075497
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00728300 Issued in NJ
Practice address
506 Broadway
Bayonne, NJ 07002-3712
Phone
(201) 471-7012
Fax
(201) 471-7014
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00728300 NJ Primary

Addresses

Primary practice location

506 Broadway
Bayonne, NJ 07002-3712

Mailing address

305 Armstrong Ave
Jersey City, NJ 07305-2101
Phone (201) 333-8575

Other practice location 1

210 Hamburg Tpke
Wayne, NJ 07470-2116
Phone (973) 942-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215000832 NJ Practitioner - Nurse Practitioner 3476811639 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Medical and Health Associates,LLC CurrentSince Nov 1, 2017 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Mar 1, 2019 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Mar 1, 2019 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Riverside Medical Group Past Accepting new patients

Locations

506 Broadway
Bayonne, NJ 07002
Phone (201) 471-7012

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

150 Warren St
Jersey City, NJ 07302
Phone (201) 309-3000

196 Jewett Ave
Jersey City, NJ 07304
Phone (201) 332-3354

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: ssingh76833@direct.optum.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1477075497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 ARMSTRONG AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052101",
            "telephone_number": "201-333-8575",
            "fax_number": "201-333-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023712",
            "telephone_number": "201-471-7012",
            "fax_number": "201-471-7014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Hamburg Tpke",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "NJ",
            "postal_code": "074702116",
            "country_code": "US",
            "telephone_number": "973-942-9191",
            "fax_number": "973-942-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SINGH",
        "first_name": "SAMANTHA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00728300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.