Active NPI
Samantha Nazareth, M.D.
- Gastroenterology Physician
- Forest Hills, NY
National Provider Identifier
1548429426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 258328
- Practice address
- 10840 Queens Blvd
Forest Hills, NY 11375-5361 - Phone
- (718) 459-8460
- NPI assigned
- Jun 5, 2008
- Last updated
- Jul 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 258328 | NY | Primary |
Addresses
Primary practice location
10840 Queens Blvd
Forest Hills, NY 11375-5361
Mailing address
10840 Queens Blvd
Box 130
Forest Hills, NY 11375-5361
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 |
|---|---|---|---|
| 258328 | NY | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1548429426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10840 QUEENS BLVD",
"address_2": "BOX 130",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10840 QUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755361",
"telephone_number": "718-459-8460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAZARETH",
"first_name": "SAMANTHA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-05",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "258328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.