Active NPI
Samson Bernard, NP
- Family Nurse Practitioner
- Maplewood, NJ
National Provider Identifier
1780517417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 360013
- Practice address
- 7 Berkeley St
Maplewood, NJ 07040-3316 - Phone
- (862) 205-9172
- NPI assigned
- Jun 3, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 360013 | NY | Primary |
Addresses
Primary practice location
7 Berkeley St
Maplewood, NJ 07040-3316
Mailing address
7 Berkeley St
Maplewood, NJ 07040-3316
Phone (862) 205-9172
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 360013 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1780517417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 BERKELEY ST",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403316",
"telephone_number": "862-205-9172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 BERKELEY ST",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403316",
"telephone_number": "862-205-9172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNARD",
"first_name": "SAMSON",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-03",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "360013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.