NPIMap

Individual provider Active NPI

Salem Samra, M.D.

  • Plastic Surgery Physician
  • Holmdel, NJ
National Provider Identifier
1609050939
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
25MA09104300 Issued in NJ
Practice address
733 N Beers St
Suite U1
Holmdel, NJ 07733-1528
Phone
(732) 739-2100
Fax
(732) 727-8039
NPI assigned
Dec 21, 2007
Last updated
Sep 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 25MA09104300 NJ Primary

Addresses

Primary practice location

733 N Beers St
Suite U1
Holmdel, NJ 07733-1528

Mailing address

733 N Beers St
Suite U1
Holmdel, NJ 07733-1528
Phone (732) 739-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130520000265 NJ Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 8921245580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Baylor College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samra Plastic and Reconstructive Surgery LLCGroup PAC ID 3274545330, 9 clinicians

Practice addresses (Care Compare)

733 N Beers St
Suite U1
Holmdel, NJ 07733-1513
Phone (732) 739-2100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09104300NJMDPlastic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: salem.samra@samra.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1609050939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 N BEERS ST",
            "address_2": "SUITE U1",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331528",
            "telephone_number": "732-739-2100",
            "fax_number": "732-727-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 N BEERS ST",
            "address_2": "SUITE U1",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331528",
            "telephone_number": "732-739-2100",
            "fax_number": "732-727-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRA",
        "first_name": "SALEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-21",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA09104300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.