William Richard Samek, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY2915 Issued in FL

Practice address

7241 SW 63Rd Ave Ste 203-C
South Miami, FL 33143-4838

Phone

(305) 552-5000

Fax

(305) 552-5000

NPI assigned

Dec 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2018 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811065188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7241 SW 63RD AVE STE 203-C",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434838",
            "telephone_number": "305-552-5000",
            "fax_number": "305-552-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 SW 63RD AVE STE 203-C",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434838",
            "telephone_number": "305-552-5000",
            "fax_number": "305-552-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMEK",
        "first_name": "WILLIAM",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY2915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in South Miami, FL
• Providers in South Miami, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.