Active NPI
Susanna Samuel, PT, DPT
- Physical Therapist
- Pasadena, TX
National Provider Identifier
1689204752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1324650
- Practice address
- 4600 Fairmont Pkwy Ste 205
Pasadena, TX 77504-3337 - Phone
- (281) 998-8600
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1324650 | TX | Primary |
Addresses
Primary practice location
4600 Fairmont Pkwy Ste 205
Pasadena, TX 77504-3337
Mailing address
5419 Pointed Leaf Dr
Missouri City, TX 77459-1599
Phone (281) 770-2265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200213001437 | TX | Practitioner - Physical Therapist in Private Practice | 7810323714 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1324650 | TX | MD | Physical Therapist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1689204752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5419 POINTED LEAF DR",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774591599",
"telephone_number": "281-770-2265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 FAIRMONT PKWY STE 205",
"city": "PASADENA",
"state": "TX",
"postal_code": "775043337",
"telephone_number": "281-998-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SUSANNA",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1324650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.