Samantha Dmytrow

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

3911 Richmond Ave
Staten Island, NY 10312-5110

Phone

(718) 948-3232

NPI assigned

Nov 9, 2020

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 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Denis Ali Eder, LMHC

  • Mental Health Counselor
  • Staten Island, NY
  • NPI 1770477929
  Medicare reassignment

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 365 Mental Health Counseling PLLC

  • Mental Health Counselor
  • Lloyd Harbor, NY
  • NPI 1417787904
  Medicare reassignment NPD
• Sunrise Wellness Mental Health Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Staten Island, NY
  • NPI 1992698534
  NPD Authorized official

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1568064228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125110",
            "telephone_number": "718-948-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DMYTROW",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131624228",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dmcginnis, Inc.
• Anastasia Dmitt, M.S., SP.ED
• Katarzyna Dmochowska, DPT
• DMV Home Care Inc
• DMW Speech Services Slppllc
• Thao Doan, M.D.
• Omar Dobie
• Nicole Michelle Dobrykina
• Deborah Dobson Alves, L.C.S.W.
• Dawn Doccola

• Addiction (Substance Use Disorder) Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.

Verify at the official NPI Registry.