Individual provider Active NPI

Samer M Nuhaily, MD

  • Rheumatology Physician
  • Saint Paul, MN
National Provider Identifier
1780879213
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
74171 Issued in MN
Practice address
401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone
(651) 254-7800
NPI assigned
Sep 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A100357 CA
Rheumatology Physician 207RR0500X 74171 MN Primary
Internal Medicine Physician 207R00000X 12457 NV
Internal Medicine Physician 207R00000X 036.118507 IL
Rheumatology Physician 207RR0500X 036118507 IL
Rheumatology Physician 207RR0500X PT21515 ND

Addresses

Primary practice location

401 Phalen Blvd
Saint Paul, MN 55130-5302

Mailing address

602 West University Avenue
NCW4 - Provider Enrollment Specialist
Urbana, IL 61801-2530
Phone (217) 383-6792

Other practice location 1

1000 Mon Health Medical Park Dr Ste 1104
Morgantown, WV 26505-1143
Phone (043) 598-7296

Other practice location 2

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

Other practice location 3

10480 Gunpowder Falls St
Las Vegas, NV 89183-7929
Phone (702) 616-6936

Other practice location 4

360 Station Dr Fl 3
Crystal Lake, IL 60014-7978
Phone (815) 338-6600

Other practice location 5

2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

Other practice location 6

4309 W Medical Center Dr Ste B202
McHenry, IL 60050
Phone (815) 338-6600

Other identifiers 1

IdentifierTypeStateIssuer
036118507OtherILSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250821000309 WV Practitioner - Rheumatology 2961584024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monongalia County General Hospital CompanyGroup PAC ID 9638073380, 241 clinicians

Practice addresses (Care Compare)

1000 Mon Health Medical Park Dr
Suite 1104
Morgantown, WV 26505-1143
Phone (304) 598-7296

Hospital & facility affiliations

  • Mon Health Medical Center Hospital, Morgantown, WV, CCN 510024
  • Uniontown Hospital Hospital, Uniontown, PA, CCN 390041
  • Upmc Greene Hospital, Waynesburg, PA, CCN 390150
  • Mon Health Marion Hospital, Whitehall, WV, CCN 510093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A100357CAMDInternal Medicine Physician
036.118507ILMDInternal Medicine Physician
036118507ILMDRheumatology Physician
PT21515NDMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health CurrentSince Aug 23, 2024 Accepting new patients
Trinity Health Current Accepting new patients
Monongalia County General Hospital Company Internal Medicine CurrentSince May 5, 2025 Accepting new patients
Trinity Health CurrentSince Aug 23, 2024 Accepting new patients
Monongalia County General Hospital Company Past Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

2305 37th Ave SW
Minot, ND 58701
Phone (701) 418-8550

101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

1000 Mon Health Medical Park Dr
Ste 1104
Morgantown, WV 26505
Phone (304) 598-7296

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1780879213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 WEST UNIVERSITY AVENUE",
            "address_2": "NCW4 - PROVIDER ENROLLMENT SPECIALIST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012530",
            "telephone_number": "217-383-6792",
            "fax_number": "217-326-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Mon Health Medical Park Dr Ste 1104",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265051143",
            "country_code": "US",
            "telephone_number": "043-598-7296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053494",
            "country_code": "US",
            "telephone_number": "304-598-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10480 Gunpowder Falls St",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891837929",
            "country_code": "US",
            "telephone_number": "702-616-6936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-418-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4309 W Medical Center Dr Ste B202",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "60050",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-385-3256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUHAILY",
        "first_name": "SAMER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-07",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A100357",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "74171",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "12457",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.118507",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036118507",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "ND",
            "license": "PT21515",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036118507",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.