Samuel K Self, D.N.P.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R242089 Issued in MD

Practice address

22 S Greene St
Baltimore, MD 21201-1544

Phone

(410) 328-0241

NPI assigned

Dec 13, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

15 of 100Reported as group

Quality

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Bestgate Anesthesia LLC

  • Anesthesiology Physician
  • Annapolis, MD
  • NPI 1568889327

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Shock Trauma Associates, P.a.

  dba Shock Trauma Associates

  • Emergency Care Clinic/Center
  • Baltimore, MD
  • NPI 1679512909
  Medicare reassignment NPD
• University of Maryland Medical System Corporation

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
  • NPI 1508807355

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Maryland Expresscare LLC

  dba Maryland ExpressCare

  • Land Ambulance
  • Baltimore, MD
  • NPI 1134835911
  NPD

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

{
    "created_epoch": "1449964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1538534771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "credential": "D.N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-13",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R242089",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R242089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Self-Determined Recovery LLC
• Self-Determined Recovery LLC
• Self-Realized Counseling Services, LLC
• Abigail Ruth Self, CRNP
• Caitlin Self, MS, CNS, LDN
• Selfless Life, LLC
• Stephen Lev Seliger, M.D.
• Eva Seligman, M.D.
• Omar Selim
• Selima Jumarali, PHD

• Certified Registered Nurse Anesthetist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.