Individual provider Active NPI

Samuel Brayer, MD

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1497214324
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.149436 Issued in OH
Practice address
7502 State Rd Ste 3350
Cincinnati, OH 45255-2801
Phone
(724) 448-0529
NPI assigned
Mar 19, 2019
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Pediatrics Physician 208000000X 35.149436 OH Primary

Addresses

Primary practice location

7502 State Rd Ste 3350
Cincinnati, OH 45255-2801

Mailing address

7502 State Rd Ste 3350
Cincinnati, OH 45255-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231215000670 OH Practitioner - Pediatric Medicine 3476902412 Reassigns benefits to 1 organization
I20250204003163 KY Practitioner - Pediatric Medicine 3476902412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.149436OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Community Health Services Network Pediatrics Current Accepting new patients
CHMC Community Health Services Network Pediatrics CurrentSince Nov 9, 2023 Accepting new patients
CHMC Community Health Services Network Pediatrics Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

10032 Demia Way
Florence, KY 41042
Phone (859) 647-6700

3333 Burnet Ave
#35021
Cincinnati, OH 45229

3333 Burnet Ave
#5018
Cincinnati, OH 45229
Phone (513) 636-4315

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

7502 State Rd
Ste 3350
Cincinnati, OH 45255
Phone (513) 231-3345

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/FmRItZc30RH60LjxwsIxQM4HGo6XcQXK/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1497214324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 STATE RD STE 3350",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7502 STATE RD STE 3350",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552801",
            "telephone_number": "724-448-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAYER",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.149436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.