Individual provider Active NPI

Amiram Samin, M.D.

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1790761807
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
158884-1 Issued in NY
Practice address
450 Clarkson Ave
2ND Floor
Brooklyn, NY 11203-2056
Phone
(718) 270-1603
Fax
(718) 270-2667
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 158884-1 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
2ND Floor
Brooklyn, NY 11203-2056

Mailing address

450 Clarkson Ave
Box 1262
Brooklyn, NY 11203-2056
Phone (718) 270-8867

Other identifiers 1

IdentifierTypeStateIssuer
01150536MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100730000169 NY Practitioner - Diagnostic Radiology 5597898379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2094 Pitkin Ave
Brooklyn, NY 11207-3509
Phone (718) 388-5889

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158884-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. CurrentSince Jan 1, 2003 Accepting new patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Physicians of Brooklyn, Inc. Diagnostic Radiology CurrentSince Jan 1, 2003 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Sep 21, 2022 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Sep 21, 2022 Accepting new patients

Locations

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

2094 Pitkin Ave
Brooklyn, NY 11207
Phone (718) 240-0400

450 Clarkson Ave
Fl 2
Brooklyn, NY 11203
Phone (718) 270-1081

450 Clarkson Ave
#1198
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#1262
Brooklyn, NY 11203
Phone (718) 270-7379

100 N Portland Ave
Brooklyn, NY 11205
Phone (718) 260-7500

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: asamin1055910@nychhc.direct-ci.com

Organizations & group practices 6

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 1

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1790761807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-8867",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-1603",
            "fax_number": "718-270-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMIN",
        "first_name": "AMIRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "158884-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01150536",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.