Individual provider Active NPI

Tamika Samuels, LPN

  • Licensed Practical Nurse
  • Pleasantville, NY
National Provider Identifier
1669131892
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
326425 Issued in NY
Practice address
1075 Broadway
Pleasantville, NY 10570-2346
Phone
(914) 741-4516
NPI assigned
Dec 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 326425 NY Primary

Addresses

Primary practice location

1075 Broadway
Pleasantville, NY 10570-2346

Mailing address

1075 Broadway
Pleasantville, NY 10570-2346
Phone (914) 741-4516

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Pleasantville

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
326425NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1669131892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 BROADWAY",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702346",
            "telephone_number": "914-741-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BROADWAY",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702346",
            "telephone_number": "914-741-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "TAMIKA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "326425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pleasantville",
            "affiliation": "N",
            "address_1": "1075 Broadway",
            "city": "Pleasantville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105702346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasantville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.