NPIMap

Individual provider Active NPI

Mark Samuelson, M.D.

  • Family Medicine Physician
  • Scituate, MA
National Provider Identifier
1679502405
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
160446 Issued in MA
Practice address
56 New Driftway
Suite 301
Scituate, MA 02066
Phone
(781) 544-1388
Fax
(781) 544-3396
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 160446 MA Primary

Addresses

Primary practice location

56 New Driftway
Suite 301
Scituate, MA 02066

Mailing address

56 New Driftway Ste 301
Scituate, MA 02066-4533
Phone (781) 544-1388

Other identifiers 4

IdentifierTypeStateIssuer
1679502405OtherBCBS
710838OtherMAHARVARD PILGRAM
04099589OtherEVERCARE
J22693OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000261 MA Practitioner - Family Practice 6901866607 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pembroke Medical Associates IncGroup PAC ID 3678992955, 26 clinicians

Practice addresses (Care Compare)

308 Kingstown Way
Duxbury, MA 02332-4647
Phone (508) 789-3345

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160446MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pembroke Medical Associates Inc CurrentSince Aug 1, 2024 Accepting new patients
Pai Participant Ma PC CurrentSince Sep 1, 2024 Accepting new patients
Healthcare South PC Family Medicine CurrentSince Mar 1, 2016 Accepting new patients
South Shore Medical Investors, LLC Past Accepting new patients
Plymouth Medical Investors, LLC Past Accepting new patients

Locations

308 Kingstown Way
Duxbury, MA 02332
Phone (781) 585-5561

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

56 New Driftway
Scituate, MA 02066
Phone (781) 544-3434

56 New Driftway
Ste 301
Scituate, MA 02066
Phone (781) 383-6261

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1679502405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 NEW DRIFTWAY STE 301",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020664533",
            "telephone_number": "781-544-1388",
            "fax_number": "781-544-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 NEW DRIFTWAY",
            "address_2": "SUITE 301",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "02066",
            "telephone_number": "781-544-1388",
            "fax_number": "781-544-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "160446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1679502405",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRAM",
            "identifier": "710838",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "04099589",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J22693",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scituate, MA

Sources for this page

Verify at the official NPI Registry.