Active NPI
Samantha Biersack
- Specialist
- East Northport, NY
National Provider Identifier
1730860313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1362245
- Practice address
- 3 Shelby CT
East Northport, NY 11731-4946 - Phone
- (516) 672-4622
- NPI assigned
- Jul 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1362245 | NY | Primary |
Addresses
Primary practice location
3 Shelby CT
East Northport, NY 11731-4946
Mailing address
3 Shelby CT
East Northport, NY 11731-4946
Phone (516) 672-4622
Other names 1
- Samantha Reeps
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1362245 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1730860313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 SHELBY CT",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117314946",
"telephone_number": "516-672-4622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 SHELBY CT",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117314946",
"telephone_number": "516-672-4622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIERSACK",
"first_name": "SAMANTHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-27",
"last_updated": "2023-07-27",
"certification_date": "2023-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "1362245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "REEPS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in East Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.