Individual provider Active NPI

Samantha Britni Allen, MD

  • Pediatric Otolaryngology Physician
  • Hollywood, FL
National Provider Identifier
1578957486
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
ME149583 Issued in FL
Practice address
1131 N 35TH Ave Ste 300
Hollywood, FL 33021-5403
Phone
(954) 265-1616
Fax
(954) 893-6323
NPI assigned
Mar 28, 2015
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Otolaryngology Physician 207YP0228X ME149583 FL Primary

Addresses

Primary practice location

1131 N 35TH Ave Ste 300
Hollywood, FL 33021-5403

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other practice location 1

5830 Coral Ridge Dr Ste 140
Coral Springs, FL 33076-3388
Phone (954) 265-1616

Other identifiers 1

IdentifierTypeStateIssuer
111216100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210911000121 FL Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 2163718966 Reassigns benefits to 1 organization
I20240213000834 DC Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 2163718966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Sep 1, 2021 Accepting new patients
South Broward Hospital District Pediatric Otolaryngology CurrentSince Sep 1, 2021 Accepting new patients
Children's Hospital CurrentSince Jan 6, 2024 Accepting new patients
Children's Hospital CurrentSince Jan 6, 2024 Accepting new patients
Children's Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 884-4177

5830 Coral Ridge Dr
Ste 140
Coral Springs, FL 33076
Phone (954) 265-1616

1131 N 35th Ave
Ste 300
Hollywood, FL 33021
Phone (954) 265-1616

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5663

Interoperability endpoints

  • Direct secure messaging: sallen745291@soc.inova.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1578957486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403",
            "telephone_number": "954-265-1616",
            "fax_number": "954-893-6323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5830 Coral Ridge Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330763388",
            "country_code": "US",
            "telephone_number": "954-265-1616",
            "fax_number": "954-265-1615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SAMANTHA",
        "middle_name": "BRITNI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-28",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME149583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111216100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.