Samir K Kassicieh, DO, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SAMIR K KASSICIEH, DO, PC

Practice address

1010 Bridge Blvd SW
Suite a
Albuquerque, NM 87105-3765

Phone

(505) 877-0212

Fax

(505) 877-0139

NPI assigned

Jun 11, 2008

Organization subpart

No

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

Authorized official

Name

Samir K Kassicieh, D. O.NPI 1730254350

Title

Owner

Phone

(505) 877-0212

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samir Kassicieh, DO

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1730254350
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1649430802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12435",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871950435",
            "telephone_number": "505-877-0212",
            "fax_number": "505-877-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BRIDGE BLVD SW",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053765",
            "telephone_number": "505-877-0212",
            "fax_number": "505-877-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMIR K KASSICIEH, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "KASSICIEH",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-877-0212",
        "authorized_official_credential": "D. O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40279",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samaritan Counseling Center of Albuquerque
• Chitra Neela Sambasivan, MD
• Steven Sambrano, PA-C
• Sachielle Samedi, CCC-SLP
• Von Graeger Samedi, M.D., PH.D.
• Madison Samis
• Megan Brooke Sammeth, BSN RN
• Sarah Sammon
• Stephen K Samoei, NP
• Natasha Samora

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.