Individual provider Active NPI

Samantha Sarah Massenzio

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1497391262
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD493849 Issued in PA
Practice address
840 Walnut St Ste 1020
Philadelphia, PA 19107-5180
Phone
(800) 331-6634
NPI assigned
Nov 26, 2019
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD493849 PA Primary
Internal Medicine Physician 207R00000X MT226001 PA

Addresses

Primary practice location

840 Walnut St Ste 1020
Philadelphia, PA 19107-5180

Mailing address

840 Walnut St Ste 1020
Philadelphia, PA 19107-5180
Phone (800) 331-6634

Other names 1

  • Samantha Sarah Ip Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smassenzio@midatlret.intellechartdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20260515001887 PA Practitioner - Ophthalmology 8921485780

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Johns Hopkins University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wills Eye Ophthalmology Clinic, IncGroup PAC ID 9133025166, 146 clinicians

Practice addresses (Care Compare)

840 Walnut St
Philadelphia, PA 19107-5109
Phone (215) 928-3041

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT226001PAMDInternal Medicine Physician
MD493849PAMDOphthalmology Physician

Interoperability endpoints

  • Direct secure messaging: samantha.massenzio.p1@direct.willseye.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1497391262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075180",
            "telephone_number": "800-331-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075180",
            "telephone_number": "800-331-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENZIO",
        "first_name": "SAMANTHA",
        "middle_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD493849",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT226001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smassenzio@midatlret.intellechartdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "840 Walnut St Ste 1020",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191075180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "IP",
            "middle_name": "SARAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.