Active NPI
Chandy C Samuel, M.D.
- Surgery Physician
- Winfield, KS
National Provider Identifier
1528052297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 0416859
- Practice address
- 3625 Quail Ridge Rd
Winfield, KS 67156-8881 - Phone
- (620) 221-6100
- Fax
- (620) 221-7680
- NPI assigned
- Sep 8, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0416859 | KS | Primary |
| Family Medicine Physician | 207Q00000X | 04-16859 | KS |
Addresses
Primary practice location
3625 Quail Ridge Rd
Winfield, KS 67156-8881
Mailing address
3625 Quail Ridge Rd
Winfield, KS 67156-8881
Phone (620) 221-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100085170A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0416859 | KS | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Galichia Medical Group, P.a. | Family Medicine | Past | Accepting new patients |
| Pawnee Valley Community Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- chandy.samuel@khindirect.org
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Wichita, KS
- NPI 1447238621
Family Medicine
-
- General Practice Physician
- Larned, KS
- NPI 1912310822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224460800000",
"number": "1528052297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3625 QUAIL RIDGE RD",
"city": "WINFIELD",
"state": "KS",
"postal_code": "671568881",
"telephone_number": "620-221-6100",
"fax_number": "620-221-7680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 QUAIL RIDGE RD",
"city": "WINFIELD",
"state": "KS",
"postal_code": "671568881",
"telephone_number": "620-221-6100",
"fax_number": "620-221-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "CHANDY",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2008-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KS",
"license": "0416859",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "04-16859",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100085170A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winfield, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.