Individual provider Active NPI

Samson P Samuel, M.D.

  • Surgery of the Hand (Surgery) Physician
  • Warren, MI
National Provider Identifier
1679565584
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
License
4301061347 Issued in MI
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

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3258892MedicaidMI
SS061347OtherMIBCBS PIN #

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.94 of 100Reported as group
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: ssamuel@msspc.emadirect.md
  • Direct secure messaging: 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.

Verify at the official NPI Registry.