Jacob A Samander

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

241562-01 Issued in NY

Practice address

165 Main St
Ossining, NY 10562-4702

Phone

(914) 941-1263

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Family Medical Center IncGroup PAC ID 7113835380, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (2 of 6)

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• Open Door Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Port Chester, NY
  • NPI 1285893719

  NY

  Medicare reassignment Care Compare group
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brewster, NY
  • NPI 1003152240
  Care Compare group NPD
• Open Door Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Sleepy Hollow, NY
  • NPI 1619136140
  Care Compare group
• Open Door Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Saugerties, NY
  • NPI 1780166645
  Care Compare group
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ossining, NY
  • NPI 1467487637
  Care Compare group
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mamaroneck, NY
  • NPI 1487194155
  Care Compare group
• Open Door Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mount Kisco, NY
  • NPI 1629237151
  Care Compare group
• Shoreline Psychiatry of Western Connecticut, LLC

  • Psychiatry Physician
  • Norwalk, CT
  • NPI 1134251564

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1710078787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 UNIVERSITY PKWY UNIT 101",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342013012",
            "telephone_number": "914-941-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANDER",
        "first_name": "JACOB",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME63339",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "44382",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "241562-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04179026",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucy Rovito, MD
• Anjali Roye, PSY D
• Michael Franklin Rudolph, D.D.S.
• Donna D Ryan
• Aditya Safaya, M.D.
• Leneika E Satchell, DO
• Gae Elizabeth Savino, LCSW
• Susan Scheffel, MSW
• David B Schewe, LMHC, CRC
• Mark Schiffman, LCSW-R

• All providers in Ossining, NY
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.