Jaimie Vettichira Samuel, D.O

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

280311 Issued in NY

Practice address

25 Smith St FL 2
Nanuet, NY 10954-2912

Phone

(845) 623-7100

NPI assigned

Sep 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

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.

• Boston Children'S Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967
  Medicare reassignment NPD
• Medical Services of Manhasset, PC

  • Pediatrics Physician
  • Nanuet, NY
  • NPI 1659141679
  Medicare reassignment NPD
• Mount Vernon Neighborhood Health Center Inc

  • Specialist
  • Mount Vernon, NY
  • NPI 1295912541
  Medicare reassignment NPD
• Phelps Faculty Medical Affiliates University Faculty Practice Corpor

  • Pediatrics Physician
  • Nanuet, NY
  • NPI 1912853722
  Medicare reassignment NPD
• Boston Childrens Health Physicians LLP

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD
• Mount Vernon Neighborhood Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Yonkers, NY
  • NPI 1952550055
  NPD
• Eckerson Pediatric Associates, PC

  • Specialist
  • Nanuet, NY
  • NPI 1689856098
  NPD (past)

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1629479563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 POPLAR ST",
            "city": "ELMSFORD",
            "state": "NY",
            "postal_code": "105233726",
            "telephone_number": "914-409-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SMITH ST FL 2",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542912",
            "telephone_number": "845-623-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 East St SE Ste 301",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221804800",
            "country_code": "US",
            "telephone_number": "703-938-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "JAIMIE",
        "middle_name": "VETTICHIRA",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102205729",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "280311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khadijah Sall
• Charles A Sallahian, DC
• Foluke Onaolapo Salu, M.D
• Nellie Anne Salvant, LPN
• Barbara Salvatore
• Kunjama Samuel, RN
• Stephany Sanchez
• Nihal S Sandhu, MD
• Srinivasa H Sanjev, MD
• Laura Sanjuan Cantillo

• Pediatrics Physician in Nanuet, NY
• Providers in Nanuet, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.