Individual provider Active NPI

Samantha Pearl Zuckerman, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1730421678
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD455287 Issued in PA
Practice address
3400 Spruce St
1St Floor Penn Tower
Philadelphia, PA 19104-4238
Phone
(215) 662-3264
NPI assigned
Mar 18, 2013
Last updated
Mar 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 26NJ01010600 NJ
Diagnostic Radiology Physician 2085R0202X MD455287 PA Primary

Addresses

Primary practice location

3400 Spruce St
1St Floor Penn Tower
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
1St Floor Penn Tower
Philadelphia, PA 19104-4238
Phone (215) 662-3264

Other practice location 1

1865 Route 70 E Ste 130
Cherry Hill, NJ 08003-2005
Phone (856) 433-2535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190809000856 PA Practitioner - Diagnostic Radiology 8628384575 Reassigns benefits to 1 organization
I20200329000073 NJ Practitioner - Diagnostic Radiology 8628384575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Icahn School of Medicine at Mount Sinai, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 349-5454

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26NJ01010600NJMDDiagnostic Radiology Physician
MD455287PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. Diagnostic Radiology CurrentSince Mar 10, 2020 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2019 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Mar 10, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2019 Accepting new patients

Locations

1865 Route 70 E
Ste 130
Cherry Hill, NJ 08003
Phone (856) 433-2535

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3400 Spruce St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-3005

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1730421678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1ST FLOOR PENN TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1ST FLOOR PENN TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-3264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1865 Route 70 E Ste 130",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032005",
            "country_code": "US",
            "telephone_number": "856-433-2535",
            "fax_number": "856-528-5221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZUCKERMAN",
        "first_name": "SAMANTHA",
        "middle_name": "PEARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "26NJ01010600",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD455287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.