Individual provider Active NPI

Radmila Samandarova, NP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1649033739
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353507 Issued in NY
Practice address
13665 37TH Ave
Flushing, NY 11354-4110
Phone
(000) 000-0000
NPI assigned
Feb 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 353507 NY Primary
Registered Nurse 163W00000X 713087 NY

Addresses

Primary practice location

13665 37TH Ave
Flushing, NY 11354-4110

Mailing address

14111 Grand Central Pkwy
Jamaica, NY 11435-1126
Phone (000) 000-0000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904003649 NY Practitioner - Nurse Practitioner 3375981269 Reassigns benefits to 3 organizations
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
713087NYMDRegistered Nurse
353507NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerlight Healthcare, Inc. CurrentSince Jun 23, 2024 Accepting new patients
Midland NP in Family Health PLLC CurrentSince Apr 8, 2026 Accepting new patients
Team Care Medical PLLC CurrentSince Jul 27, 2025 Accepting new patients
Centerlight Certified Home Health Agency Past Accepting new patients

Locations

1250 Waters Pl
Ste 602
Bronx, NY 10461
Phone (877) 226-8500

596 Prospect Pl
Brooklyn, NY 11238
Phone (718) 362-1450

13665 37th Ave
Flushing, NY 11354
Phone (718) 321-4200

Interoperability endpoints

  • Direct secure messaging: radmila.samandarova.1@32021.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1649033739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14111 GRAND CENTRAL PKWY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351126",
            "telephone_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13665 37TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544110",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANDAROVA",
        "first_name": "RADMILA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353507",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "713087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.