Imtiaz Renza Samad, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

208658 Issued in NY

Practice address

600 Seneca Street
Oneida Medical Associates PLLC
Oneida, NY 13421

Phone

(315) 363-1345

Fax

(315) 363-9243

NPI assigned

Jul 12, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in NY, TX2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ny Acute Care Specialists PC

  • Hospitalist Physician
  • Rome, NY
  • NPI 1528377892
  NPD (past)
• Ridge Mills Physician Services, PLLC

  • Internal Medicine Physician
  • Rome, NY
  • NPI 1902837321

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1760417992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SENECA ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212668",
            "telephone_number": "315-363-1345",
            "fax_number": "315-363-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SENECA STREET",
            "address_2": "ONEIDA MEDICAL ASSOCIATES PLLC",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "13421",
            "telephone_number": "315-363-1345",
            "fax_number": "315-363-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAD",
        "first_name": "IMTIAZ",
        "middle_name": "RENZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01679941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina M Rood, FNP
• Anne Marie Russell-Brien, DDS
• Christina Russo
• Kristin L Rutherford, FNP
• Teresa Rico Sabordo, PT
• Jamie Lee Sansone
• Matthew R Sayles, PHARMD
• Rachel E Sayles, M.S.CCC-SLP
• Ryan Scarzafava
• Sandra Schiffer, CASAC-T

• All providers in Oneida, NY
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.