Active NPI
Samuel Mwadkon Jama, M.D.
- Internal Medicine Physician
- New Rochelle, NY
National Provider Identifier
1669551743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35.088098
- Practice address
- Ambassador Medical Services
432 North Ave
New Rochelle, NY 10801-4105 - Phone
- (914) 235-2137
- Fax
- (914) 237-2139
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 210991 | NY | |
| Internal Medicine Physician | 207R00000X | 35.088098 | OH | Primary |
Addresses
Primary practice location
Ambassador Medical Services
432 North Ave
New Rochelle, NY 10801-4105
Mailing address
5140 River Creek Rd
Cleveland, OH 44124-3764
Phone (234) 855-4778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02203712 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1992
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
950 W Wooster St
Bowling Green, OH 43402-2603
Phone (844) 270-6621
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210991 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NW Ohio Hospital Medicine Physicians LLC | Single Specialty | Current | Accepting new patients |
| Theoria Medical | Single Specialty | Current | Accepting new patients |
| Blanchard Valley Regional Health Center | Single Specialty | Past | Accepting new patients |
| Ambassador Medical PC | Single Specialty | Past | Accepting new patients |
| In House Internists, Inc | Single Specialty | Past | Accepting new patients |
| Park Avenue Medical Associates, P.C. | Single Specialty | Past | Accepting new patients |
Locations
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
950 W Wooster St
Bowling Green, OH 43402
Phone (419) 354-8900
1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500
5351 Mitchaw Rd
Sylvania, OH 43560
Phone (419) 824-6699
1030 High St
Worthington, OH 43085
Phone (614) 876-7356
Interoperability endpoints
- samuel.jama@somc.medicity.net
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Findlay, OH
- NPI 1023794377
Single Specialty
-
- Geriatric Medicine (Family Medicine) Physician
- White Plains, NY
- NPI 1730138645
Single Specialty
-
- General Acute Care Hospital
- Findlay, OH
- NPI 1710920327
Single Specialty
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Findlay, OH
- NPI 1578336400
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Findlay, OH
- NPI 1710920327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718064000000",
"number": "1669551743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5140 RIVER CREEK RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441243764",
"telephone_number": "234-855-4778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AMBASSADOR MEDICAL SERVICES",
"address_2": "432 NORTH AVE",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108014105",
"telephone_number": "914-235-2137",
"fax_number": "914-237-2139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMA",
"first_name": "SAMUEL",
"middle_name": "MWADKON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2024-06-11",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "210991",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "OH",
"license": "35.088098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02203712",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Rochelle, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.