Individual provider Active NPI

Samuel Harris, MD

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Tampa, FL
National Provider Identifier
1649859000
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Emergency Medicine) PhysicianTaxonomy code 207PH0002X
License
ME169041 Issued in FL
Practice address
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone
(352) 359-9833
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospice and Palliative Medicine (Emergency Medicine) Physician 207PH0002X ME169041 FL Primary

Addresses

Primary practice location

17 Davis Blvd Ste 308
Tampa, FL 33606-3438

Mailing address

17 Davis Blvd Ste 308
Tampa, FL 33606-3438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240724003104 FL Practitioner - Emergency Medicine 1557807781 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chapters Health Palliative Care, LLC CurrentSince Dec 1, 2024 Accepting new patients
Inphynet Contracting Services LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

12470 Telecom Dr
Ste 300
Temple Terrace, FL 33637
Phone (813) 871-8111

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

2144 Welbilt Blvd
Trinity, FL 34655
Phone (727) 376-3658

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Organizations & group practices 2

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1649859000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438",
            "telephone_number": "352-359-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME169041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.