Individual provider Active NPI

Ahmed Samra, MD

  • Student in an Organized Health Care Education/Training Program
  • Houston, TX
National Provider Identifier
1790537884
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6410 Fannin St Ste 1400
Houston, TX 77030-5389
Phone
(832) 325-7125
Fax
(713) 512-2200
NPI assigned
Apr 3, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6410 Fannin St Ste 1400
Houston, TX 77030-5389

Mailing address

6410 Fannin St Ste 1400
Houston, TX 77030-5389
Phone (832) 325-7125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260526003078 MI Practitioner - General Surgery 0648740159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katranji Reconstructive Surgery Institute, PLLCGroup PAC ID 7719052414, 6 clinicians

Practice addresses (Care Compare)

2111 Merritt Rd
Suite 202
East Lansing, MI 48823-6916
Phone (517) 332-4263

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1790537884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305389",
            "telephone_number": "832-325-7125",
            "fax_number": "713-512-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305389",
            "telephone_number": "832-325-7125",
            "fax_number": "713-512-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRA",
        "first_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.