Mohammad Samiullah, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

T4675 Issued in TX

Practice address

1000 S Beckham Ave
Tyler, TX 75701-1908

Phone

(903) 590-5611

Fax

(903) 535-6884

NPI assigned

Apr 6, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Hospitalist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Texas Specialty PhysiciansGroup PAC ID 6305901927, 59 clinicians

Lufkin Physician Services PAGroup PAC ID 1153542998, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475
• Ut Health East Texas Carthage Hospital Hospital, Carthage, TX, CCN 450210
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msamiullah707220@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Lufkin Physician Services PA

  • Hospitalist Physician
  • Lufkin, TX
  • NPI 1881093789
  Medicare reassignment Care Compare group NPD
• Texas Specialty Physicians

  • Family Medicine Physician
  • Palestine, TX
  • NPI 1558521179

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Texas - Burnet PLLC

  • Hospitalist Physician
  • Denison, TX
  • NPI 1265275887

  Internal Medicine

  Medicare reassignment NPD
• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment NPD
• Prestige MD Concierge PLLC

  • Internal Medicine Physician
  • Lindale, TX
  • NPI 1730972910
  NPD Authorized official
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Texas Specialty Physicians

  • Psychiatry Physician
  • Palestine, TX
  • NPI 1861378168
  NPD
• Texas Specialty Physicians

  • Family Medicine Physician
  • Ennis, TX
  • NPI 1992932032
  NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD
• Carthage Hospital, LLC

  • General Acute Care Hospital
  • Carthage, TX
  • NPI 1538667035
  NPD (past)
• Henderson Hospital, LLC

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carthage Hospital, LLC

  • General Acute Care Hospital
  • Carthage, TX
  • NPI 1538667035
  Care Compare affiliation
• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Henderson Hospital, LLC

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  Care Compare affiliation
• Piney Woods Healthcare System, L.P.

  • General Acute Care Hospital
  • Lufkin, TX
  • NPI 1487607792
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1578025607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "903-590-5611",
            "fax_number": "903-535-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "903-590-5611",
            "fax_number": "903-535-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMIULLAH",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-06",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "T4675",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T4675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perla Salazar, LCDC
• Pamela A Saldana Jentz, OT
• Saad Mohammed Saleem, DO
• Sam'S Club Optical
• Syed Raheel Sameeruddin, M.D.
• Kaitlin Samples
• Sams East Inc
• Sarah Samuel, DDS
• Blake Sanca, COTA
• Juan Carlos Sanchez Hernandez, SA-C

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.
• 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.