Siji Samuel, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1029999 Issued in TX

Practice address

411 N Washington Ave Ste 6000
Dallas, TX 75246-1789

Phone

(214) 358-2300

Fax

(214) 579-6988

NPI assigned

Sep 24, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Nephrology AssociatesGroup PAC ID 3870403819, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
• Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssamuel52317@direct.acumenmd.com
• FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Dallas Nephrology Associates

  • Nephrology Physician
  • Dallas, TX
  • NPI 1861440109
  Medicare reassignment Care Compare group NPD
• Dallas Nephrology Associates

  • Ambulatory Surgical Clinic/Center
  • Dallas, TX
  • NPI 1053634030
  NPD

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

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253
  Care Compare affiliation
• Texas Heart Hospital of the Southwest LLC

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1609855139
  Care Compare affiliation

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1801567359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LBJ FWY STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752346065",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 6000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461789",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SIJI",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1029999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1029999",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernice S Samuel, FNP-C
• David Samuel, PHARMD RPH
• Elsabet Samuel
• Gincy Samuel, MD
• Maraki Samuel
• Simi Mariam Samuel, NP
• Susamma Samuel
• Danielle Nicole Samuelson, LM, CPM
• Eric Michael Samuelson, MD
• McKenzie Louis Samuelson, CRNA

• Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.