Individual provider Active NPI

Stephanie P Samph, PH.D.

  • Psychologist
  • Boston, MA
National Provider Identifier
1831346782
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY5000324 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-5202
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 31223 CA
Psychologist 103T00000X PSY5000324 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St
Boston, MA 02114-2621
Phone (508) 524-3343

Other practice location 1

3350 La Jolla Village Dr
San Diego, CA 92161-2902
Phone (858) 552-8585

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephanie.samph@va.gov

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608003056 MA Practitioner - Clinical Psychologist 6204293038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY5000324MAMDPsychologist
31223CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jun 15, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Jun 15, 2023 Accepting new patients
South Shore Mental Health Past Accepting new patients
South Shore Mental Health Center, Inc. Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: samph.stephanie.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1831346782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "508-524-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-5202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 La Jolla Village Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921612902",
            "country_code": "US",
            "telephone_number": "858-552-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPH",
        "first_name": "STEPHANIE",
        "middle_name": "P",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31223",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "PSY5000324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.samph@va.gov",
            "affiliation": "N",
            "endpointDescription": "Skype for business",
            "address_1": "3350 La Jolla Village Dr",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921612902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.