Active NPI
Samson P Samuel, M.D.
- Surgery of the Hand (Surgery) Physician
- Warren, MI
National Provider Identifier
1679565584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery of the Hand (Surgery) Physician
- License
- 4301061347
- Practice address
- 11012 E 13 Mile Rd
Suite 112
Warren, MI 48093-2572 - Phone
- (586) 573-6880
- Fax
- (586) 573-2562
- NPI assigned
- Aug 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery of the Hand (Surgery) Physician | 2086S0105X | 4301061347 | MI | Primary |
Addresses
Primary practice location
11012 E 13 Mile Rd
Suite 112
Warren, MI 48093-2572
Mailing address
11012 E 13 Mile Rd Ste 112
Warren, MI 48093-2546
Phone (586) 582-0864
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3258892 | Medicaid | MI | |
| SS061347 | Other | MI | BCBS PIN # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 81.94 of 100
- Quality
- 79.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 59.99
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Interoperability endpoints
- ssamuel@msspc.emadirect.md
- ssamuel1150131@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1679565584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11012 E 13 MILE RD STE 112",
"city": "WARREN",
"state": "MI",
"postal_code": "480932546",
"telephone_number": "586-582-0864",
"fax_number": "586-582-0964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11012 E 13 MILE RD",
"address_2": "SUITE 112",
"city": "WARREN",
"state": "MI",
"postal_code": "480932572",
"telephone_number": "586-573-6880",
"fax_number": "586-573-2562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SAMSON",
"middle_name": "P",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-17",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0105X",
"taxonomy_group": "",
"desc": "Surgery, Surgery of the Hand",
"state": "MI",
"license": "4301061347",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3258892",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN #",
"identifier": "SS061347",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.