Samson Jesudass, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K3262 Issued in TX

Practice address

1201, West 38TH Street,Medical Director
Seton Medical Center ,,Admin
Austin, TX 78705-1006

Phone

(512) 324-1484

NPI assigned

Jun 15, 2006

Last updated

Jun 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Ascension Seton

  dba Ascension Seton Bastrop Health Center

  • Rural Health Clinic/Center
  • Bastrop, TX
  • NPI 1700392602

  Corporate Director

  CMS ownership
• Ascension Seton

  dba Ascension Seton Southwest

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1750499273

  Corporate Director

  CMS ownership

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.

• Ascension Seton

  dba SEBD Professional Support Services

  • Family Medicine Physician
  • Luling, TX
  • NPI 1215118609

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1619911385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 PECAN STREET",
            "city": "LULING",
            "state": "TX",
            "postal_code": "78648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201, WEST 38TH STREET,MEDICAL DIRECTOR",
            "address_2": "SETON MEDICAL CENTER ,,ADMIN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051006",
            "telephone_number": "512-324-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESUDASS",
        "first_name": "SAMSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K3262",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113783804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Sprengle, LLC
• Jessie White Psychotherapy PLLC
• Candace Sherrene Jessup
• Nicholas Edward Jessup
• Jester Dental PC (Jester Village Dental)
• Patsy Ann Jevas, C.R.N.A.
• Beth Faulkner Jewell, L.P.C.
• Janet N Jewell, MD
• Ashleigh Danielle Jewett, LCSW
• Courtney Jewett, MS, LPC

• Internal Medicine Physician in Austin, TX
• Providers in Austin, 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 Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.