Individual provider Active NPI

Samantha A Urell, LMSW, CASAC-T

  • Social Worker
  • New York, NY
National Provider Identifier
1689219750
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
104972 Issued in NY
Practice address
1900 2ND Ave FL 12
New York, NY 10029
Phone
(212) 360-7489
NPI assigned
Nov 13, 2019
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 104972 NY Primary

Addresses

Primary practice location

1900 2ND Ave FL 12
New York, NY 10029

Mailing address

1900 2ND Ave FL 12
New York, NY 10029-7406
Phone (212) 360-7489

Other identifiers 1

IdentifierTypeStateIssuer
1163MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address surell@cchphealthcare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220803001473 NY Practitioner - Clinical Social Worker 9335521624 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104972NYMDSocial Worker
092930NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Social Worker CurrentSince Jul 1, 2022 Accepting new patients
Center for Comprehensive Health Practice Inc PastSince Nov 17, 2019 Accepting new patients

Locations

134 N 4th St
Brooklyn, NY 11249

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1689219750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 2ND AVE FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297406",
            "telephone_number": "212-360-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 2ND AVE FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-360-7489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URELL",
        "first_name": "SAMANTHA",
        "middle_name": "A",
        "credential": "LMSW, CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1163",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "surell@cchphealthcare.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1900 2nd Ave Fl 12",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100297406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.