Samantha Agatha Mucha, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MB10402700 Issued in NJ

Practice address

714 10TH St
Secaucus, NJ 07094-2921

Phone

(201) 863-3346

NPI assigned

Apr 17, 2015

Last updated

Jan 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: smucha77266@direct.optum.com

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.

• Riverside Medical Group

  • Nurse Practitioner
  • Secaucus, NJ
  • NPI 1053867598
  NPD (past)

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1770970782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 10TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942921",
            "telephone_number": "201-863-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 10TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942921",
            "telephone_number": "201-863-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Essex St",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073024508",
            "country_code": "US",
            "telephone_number": "201-268-5485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "609 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070304907",
            "country_code": "US",
            "telephone_number": "201-215-5645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Clinton St",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070302504",
            "country_code": "US",
            "telephone_number": "201-293-6387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUCHA",
        "first_name": "SAMANTHA",
        "middle_name": "AGATHA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB10402700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Secaucus, NJ
• Providers in Secaucus, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.