Shawn Kunjumon Samuel, DO, MS

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

239243 Issued in NY

Practice address

1825 Eastchester Rd
Bronx, NY 10461-2301

Phone

(718) 904-2400

Fax

(718) 904-2827

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

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 2

Specialty

Physical Medicine and Rehabilitation

Education

New York College of Osteo Medicine of New York Institute of Technology, 2002

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Cogent Medical Care PCGroup PAC ID 7315836780, 152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Montefiore Medical Center Hospital, Bronx, NY, CCN 330059
• Montefiore Mount Vernon Hospital Hospital, Mount Vernon, NY, CCN 330086

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine, Master of Science

Practice roles

Locations

Networks

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

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.

• Cogent Medical Care PC

  • Internal Medicine Physician
  • East Patchogue, NY
  • NPI 1912941238
  Medicare reassignment Care Compare group NPD
• Integrated Medical Health Wellness P C

  • Internal Medicine Physician
  • Pearl River, NY
  • NPI 1467216366
  Medicare reassignment NPD Authorized official
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Bridge RX Pharmacy Inc.

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1477118578

  Internal Medicine

  Medicare reassignment NPD
• Samuel Medical Care PLLC

  • Physical Medicine & Rehabilitation Physician
  • Pearl River, NY
  • NPI 1902628712
  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1952476988
  NPD (past)
• Montefiore Mount Vernon Hospital

  • General Acute Care Hospital
  • Mount Vernon, NY
  • NPI 1992131320
  NPD (past)

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

• Montefiore Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1952476988
  Care Compare affiliation
• Montefiore Mount Vernon Hospital

  • General Acute Care Hospital
  • Mount Vernon, NY
  • NPI 1992131320
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1649366204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MOUNTAIN AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108044722",
            "telephone_number": "914-269-8777",
            "fax_number": "888-300-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612301",
            "telephone_number": "718-904-2400",
            "fax_number": "718-904-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SHAWN",
        "middle_name": "KUNJUMON",
        "name_prefix": "Dr.",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-02-16",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239243",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "239243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02811374",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Samuel, DPT
• Joshua M Samuel
• Little Ann Samuel
• Miryam Samuel
• Savannah Samuel, PA-C
• Shelley Deborah Samuel, M.D.
• Stephannie Samuel
• Zachariah Samuel
• Dionne J. Samuels-Reid, RN
• Aaliyah Samuels, LMSW

• Hospitalist Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Hospitalist Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.