Active NPI
Robert J Samuelson, M.D.
- Anesthesiology Physician
- Dallas, TX
National Provider Identifier
1508861725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- D8423
- Practice address
- 4144 N Central Expy
#360
Dallas, TX 75204-3140 - Phone
- (214) 252-3511
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | D8423 | TX | Primary |
Addresses
Primary practice location
4144 N Central Expy
#360
Dallas, TX 75204-3140
Mailing address
4144 N Central Expy
#360
Dallas, TX 75204-3140
Phone (214) 252-3511
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122564104 | Medicaid | TX | |
| P00957309 | Other | TX | RAILROAD MEDICARE |
| 122564105 | Medicaid | TX | |
| 8A1509 | Other | TX | BCBS |
| 122564106 | Other | TX | MEDICAID CSHCN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418774400000",
"number": "1508861725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4144 N CENTRAL EXPY",
"address_2": "#360",
"city": "DALLAS",
"state": "TX",
"postal_code": "752043140",
"telephone_number": "214-252-3511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4144 N CENTRAL EXPY",
"address_2": "#360",
"city": "DALLAS",
"state": "TX",
"postal_code": "752043140",
"telephone_number": "214-252-3511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELSON",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2014-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "D8423",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122564104",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00957309",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122564105",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8A1509",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID CSHCN",
"identifier": "122564106",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.