Samir Kassicieh, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A751 Issued in NM

Practice address

1010 Bridge Blvd SW Ste a
Albuquerque, NM 87105-3765

Phone

(505) 877-0212

Fax

(505) 877-0139

NPI assigned

Nov 21, 2006

Last updated

Aug 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

Family PracticeAlso: Osteopathic Manipulative Medicine, Physical Medicine and Rehabilitation

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ambercare Home Health Home health agency, Belen, NM, CCN 327123

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Samir K Kassicieh, DO, PC

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1649430802
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ambercare Home Health Care Corporation

  dba Ambercare Home Health

  • Home Health Agency
  • Belen, NM
  • NPI 1336117621
  Care Compare affiliation

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1730254350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12435",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871950435",
            "telephone_number": "505-877-0212",
            "fax_number": "505-877-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BRIDGE BLVD SW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053765",
            "telephone_number": "505-877-0212",
            "fax_number": "505-877-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSICIEH",
        "first_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM STATE ID",
            "identifier": "A751",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40279",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Lalani Kassam, DDS
• Jennifer Kassees, FNP
• Sara Kassem
• Alexander James Kassicieh, MD
• Katina Samira Kassicieh, MD
• Kassondra Glenn LCSW LLC
• Tara Kasten, LCSW
• Holly Ray Kastendieck, MD
• Julie Kastendieck
• Nikki Katalanos, PA-C

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.