NPIMap

Individual provider Active NPI

David J Samara, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1679513477
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME31637 Issued in FL
Practice address
6555 Chester Ave Ste 1
Jacksonville, FL 32217-2279
Phone
(904) 309-6504
Fax
(904) 503-3577
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME31637 FL Primary
General Practice Physician 208D00000X ME31637 FL

Addresses

Primary practice location

6555 Chester Ave Ste 1
Jacksonville, FL 32217-2279

Mailing address

6555 Chester Ave Ste 1
Jacksonville, FL 32217-2279
Phone (904) 309-6504

Other identifiers 4

IdentifierTypeStateIssuer
15431OtherFLBLUE SHIELD
340017155OtherRAILROAD MEDICARE
059539000MedicaidFL
ME31637OtherFLMEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100108000542 FL Practitioner - Geriatric MedicinePractitioner - General PracticePractitioner - Urology 9032017694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Urology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
First Coast LTC IncGroup PAC ID 9234037896, 6 clinicians

Practice addresses (Care Compare)

3845 SE Lake Weir Ave
Cora Physical Therapy East Ocala
Ocala, FL 34480-9153
Phone (352) 693-3378

6555 Chester Ave
Suite 1
Jacksonville, FL 32217-2279
Phone (904) 265-8209

Hospital & facility affiliations

  • Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
  • Community Hospice of Northeast Florida Inc Hospice, Jacksonville, FL, CCN 101500
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135
  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052
  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
  • Vivo Healthcare Taylor Nursing home, Jacksonville, FL, CCN 105821
  • Pruitthealth - Fleming Island Nursing home, Fleming Island, FL, CCN 106124

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
First Coast LTC, Inc General Practice Current Accepting new patients
First Coast LTC Inc General Practice CurrentSince Oct 1, 1977 Accepting new patients

Locations

6555 Chester Ave
Ste 1
Jacksonville, FL 32217
Phone (904) 265-8209

6535 Chester Ave
Jacksonville, FL 32217
Phone (904) 264-3014

25 State Road 13 N
St Johns, FL 32259
Phone (904) 265-8209

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Fannie E. Taylor Home for the Aged - Care Center, Inc.Jacksonville, FL, CCN 105821 Skilled nursing facility Adp of the SNF Dec 1, 2023
Pruitthealth - Fleming IslandFleming Island, FL, CCN 106124 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2018
Jan 7, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1679513477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 CHESTER AVE STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172279",
            "telephone_number": "904-309-6504",
            "fax_number": "904-503-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 CHESTER AVE STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172279",
            "telephone_number": "904-309-6504",
            "fax_number": "904-503-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARA",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME31637",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME31637",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "15431",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340017155",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "059539000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "ME31637",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.