Michelle Karen Samuels II, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F304192 Issued in NY

Practice address

121A West 20TH Street
New York, NY 10011-2653

Phone

(212) 337-5665

Fax

(212) 337-5622

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1508804824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121A WEST 20TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112653",
            "telephone_number": "212-337-5665",
            "fax_number": "212-337-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121A WEST 20TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112653",
            "telephone_number": "212-337-5665",
            "fax_number": "212-337-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "MICHELLE",
        "middle_name": "KAREN",
        "name_prefix": "Ms.",
        "name_suffix": "II",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03293327",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400037605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon Samuels
• Jonathan Samuels, MD
• Kayla Rose Samuels, LMSW
• Krystyna Samuels
• Lorna Elaine Samuels, RN
• Rachel L Samuels, CPNP
• Sarah Emily Andreen Samuels, MD
• Susan Samuels, MD
• Brian Tuan Samuelsen, MD
• Robert Jeffrey Samuelson, M.D.

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.