Sam Rae, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA06232900 Issued in NJ

Practice address

342 Hamburg Tpke
Ste 201
Wayne, NJ 07470-2162

Phone

(973) 389-1119

Fax

(973) 389-1145

NPI assigned

Jun 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suburban Nephrology Group PAGroup PAC ID 5698712537, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Innovative Renal Care Great Falls Dialysis facility, Paterson, NJ, CCN 312627
• St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: sam.rae@sngp-nj.direct.office.nextgen.com

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.

• Suburban Nephrology Group PA

  • Specialist
  • Wayne, NJ
  • NPI 1972614022
  Medicare reassignment Care Compare group NPD Authorized official
• Renal Centers of North Jersey, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lincoln Park, NJ
  • NPI 1215908926
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Great Falls Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Paterson, NJ
  • NPI 1902147051

  Dialysis facility

  Care Compare affiliation Name & address match
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1649277294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE",
            "address_2": "STE 201",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702162",
            "telephone_number": "973-389-1119",
            "fax_number": "973-389-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE",
            "address_2": "STE 201",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702162",
            "telephone_number": "973-389-1119",
            "fax_number": "973-389-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAE",
        "first_name": "SAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA06232900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7163207",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Rabinowitz
• Hilary A Raciti, RDN, CDN
• Ori Avraham Rackovsky, M.D.
• Radiology Associates of Plymouth
• Radiology Imaging Associates
• Heather Raffer, PT
• Tangina B Rahman
• Renjini Rajan, AANP-C, GANP-C
• Rajendra V Ram, PT
• Ravishankar Ramamoorthy, M.D.

• Nephrology Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.