NPIMap

Individual provider Active NPI

Samantha Ann Ni, MD

  • Emergency Medicine Physician
  • Memphis, TN
National Provider Identifier
1619465119
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2024-02788 Issued in NC
Practice address
920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone
(901) 516-7509
NPI assigned
Apr 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-13632 AR
Emergency Medicine Physician 207P00000X 60720 TN
Emergency Medicine Physician 207P00000X 2024-02788 NC Primary

Addresses

Primary practice location

920 Madison Ave Ste 447
Memphis, TN 38103-3438

Mailing address

920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 448-5500

Other practice location 1

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210802000626 TN Practitioner - Emergency Medicine 8426460379 Reassigns benefits to 4 organizations
I20250109000555 NC Practitioner - Emergency Medicine 8426460379

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist University Emergency Physicians PLLCGroup PAC ID 4981052719, 40 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Washington PLLC Emergency Medicine Current Accepting new patients
Radar Transport LLC CurrentSince May 28, 2023 Accepting new patients

Locations

2670 Union Avenue Ext
Ste 915
Memphis, TN 38112
Phone (901) 352-0062

Interoperability endpoints

  • Direct secure messaging: sni67697@mlh.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1619465119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MADISON AVE STE 447",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033438",
            "telephone_number": "901-448-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MADISON AVE STE 447",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033438",
            "telephone_number": "901-516-7509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032807",
            "country_code": "US",
            "telephone_number": "901-545-7100",
            "fax_number": "901-545-8996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NI",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-13632",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "60720",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2024-02788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.