Michael Samko, PH.D., Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY5420 Issued in CA

Legal business name

MICHAEL SAMKO, PH.D., INC.

Practice address

2181 S El Camino Real
Suite 201
Oceanside, CA 92054-6220

Phone

(760) 721-1111

Fax

(760) 721-1116

NPI assigned

May 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael R Samko, PH.D.NPI 1396904165

Title

Owner

Phone

(760) 721-1111

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael R Samko, PHD

  • Psychologist
  • Oceanside, CA
  • NPI 1396904165
  Medicare reassignment Authorized official
• Glenn Mark Balfour, M.D.

  • Neurology Physician
  • Carlsbad, CA
  • NPI 1104931542
  NPD (past)
• Richard M Greene Jr., PHD

  • Mental Health Counselor
  • Oceanside, CA
  • NPI 1225050388
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740232727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL",
            "address_2": "SUITE 201",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546220",
            "telephone_number": "760-721-1111",
            "fax_number": "760-721-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL",
            "address_2": "SUITE 201",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546220",
            "telephone_number": "760-721-1111",
            "fax_number": "760-721-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL SAMKO, PH.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-721-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY5420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID",
            "identifier": "P00203711",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00PL54200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Michaelson
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• Rex William Michitsch, DO
• Beth Migut, M.S., CCC-SLP
• Mario D Mijares, CCS ADC II

• Psychologist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.