Samantha Johnson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091799 Issued in NY

Practice address

4419 3Rd Ave
Bronx, NY 10457-2562

Phone

(718) 364-7700

NPI assigned

Apr 6, 2017

Reactivated

Dec 27, 2017

Last updated

Jan 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urban Health Plan IncGroup PAC ID 3173517281, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

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.

• Urban Health Plan, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1265596548

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Urban Health Plan, Inc.

  dba Park Tree Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1386247542
  NPD

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1710410618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572562",
            "telephone_number": "718-364-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572562",
            "telephone_number": "718-364-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "deactivation_date": "2017-11-22",
        "reactivation_date": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "093288-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Johnson, LMSW
• Ron'Nise Theresa Johnson, PA
• Rondell Johnson
• Sabrina Johnson
• Sadie M. Johnson, M.D.
• Shannah L Johnson, R.D.
• Shaquana Johnson, LPN
• Shayona Johnson
• Shelby Jene Johnson, CPNP
• Shevonte M Johnson

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.