Individual provider Active NPI

Samuel Kwame Mensah, MD

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1619980851
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
144315 Issued in NY
Practice address
58 E Kingsbridge Rd
Bronx, NY 10468-7517
Phone
(718) 295-8243
Fax
(718) 584-3805
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 144315 NY Primary

Addresses

Primary practice location

58 E Kingsbridge Rd
Bronx, NY 10468-7517

Mailing address

58 E Kingsbrige Rd
Bronx, NY 10468
Phone (718) 295-8243

Other identifiers 1

IdentifierTypeStateIssuer
74D141OtherEMPIRE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20081231000140 NY Practitioner - Pediatric MedicinePractitioner - General Practice 6608938550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: General Practice
Education
Other, 1972
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

58 E Kingsbridge Rd
Bronx, NY 10468-7517
Phone (718) 295-8243

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1619980851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 E KINGSBRIGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10468",
            "telephone_number": "718-295-8243",
            "fax_number": "718-584-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 E KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104687517",
            "telephone_number": "718-295-8243",
            "fax_number": "718-584-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSAH",
        "first_name": "SAMUEL",
        "middle_name": "KWAME",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "144315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "74D141",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.