Samir Undavia, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

25MA08932600 Issued in NJ

Practice address

200 E 72ND St
Apartment 24 L
New York, NY 10021-4537

Phone

(607) 206-6899

NPI assigned

Apr 17, 2009

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

Enrolled in NJ

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

Specialty

Otolaryngology

Education

Albert Einstein College of Medicine of Yeshiva University, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

NJ ENT and Facial Plastic Surgery LLCGroup PAC ID 8729461553, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sundavia@njent.emadirect.md

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.

• NJ ENT and Facial Plastic Surgery LLC

  dba NJ ENT

  • Otolaryngology Physician
  • Evesham, NJ
  • NPI 1104558238
  Medicare reassignment Care Compare group NPD
• Princeton Eye & Ear LLC

  • Otolaryngology Physician
  • Lawrenceville, NJ
  • NPI 1902185945
  Medicare reassignment

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1811130057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 STONE CLIFF RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402329",
            "telephone_number": "607-206-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 72ND ST",
            "address_2": "APARTMENT 24 L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214537",
            "telephone_number": "607-206-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDAVIA",
        "first_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-17",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA08932600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Anne Umphlett, M.D.
• Marizaida Umpierre
• Ada Umubera, MSW
• Unconditional Love Doula
• Uncover Mental Health Counseling, PLLC
• Under 21 (Covenant House)
• James A Underberg, MD
• Joseph Underberg
• Michael Underriner, M.D.
• Ellen Underwood

• Otolaryngology Physician in New York, NY
• Providers in New York, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.