Individual provider Active NPI

Collin Samji

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1609568989
Registry record updated May 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60-P121463-01 Issued in NY
Practice address
930 E Tremont Ave FL 4
Bronx, NY 10460-4363
Phone
(718) 860-1111
NPI assigned
May 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60-P121463-01 NY Primary

Addresses

Primary practice location

930 E Tremont Ave FL 4
Bronx, NY 10460-4363

Mailing address

930 E Tremont Ave FL 4
Bronx, NY 10460-4363
Phone (718) 860-1111

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60-P121463-01NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685232000000",
    "number": "1609568989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 E TREMONT AVE FL 4",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604363",
            "telephone_number": "718-860-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 E TREMONT AVE FL 4",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604363",
            "telephone_number": "718-860-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMJI",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-28",
        "certification_date": "2023-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "60-P121463-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.