Individual provider Active NPI

Francine Samuels, M.D.

  • Pediatric Gastroenterology Physician
  • New Hyde Park, NY
National Provider Identifier
1629144084
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
234935 Issued in NY
Practice address
2800 Marcus Ave Ste 201
New Hyde Park, NY 11042-1113
Phone
(516) 622-6076
NPI assigned
Nov 28, 2006
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 25MA08405800 NJ
Pediatric Gastroenterology Physician 2080P0206X 234935 NY Primary

Addresses

Primary practice location

2800 Marcus Ave Ste 201
New Hyde Park, NY 11042-1113

Mailing address

601 W 57TH St Apt 33Q
New York, NY 10019-1095
Phone (551) 996-8840

Other practice location 1

155 Polifly Rd
Suite 102
Hackensack, NJ 07601-1758
Phone (551) 996-8840

Other identifiers 1

IdentifierTypeStateIssuer
234935OtherNYLICENSE

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
I20220127000484 NY Practitioner - Pediatric MedicinePractitioner - Gastroenterology 9931277795 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08405800NJMDPediatric Gastroenterology Physician
234935NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC PastSince Oct 16, 2023 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: fsamuels50002@direct.optum.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1629144084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 57TH ST APT 33Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191095",
            "telephone_number": "551-996-8840",
            "fax_number": "201-441-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MARCUS AVE STE 201",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421113",
            "telephone_number": "516-622-6076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Polifly Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011758",
            "country_code": "US",
            "telephone_number": "551-996-8840",
            "fax_number": "201-441-9949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "FRANCINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NJ",
            "license": "25MA08405800",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "234935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "234935",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.