Active NPI
Samantha Dawn Friedman, M.D.
- Pediatric Critical Care Medicine Physician
- Columbia, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 2019025439
- Practice address
- 1021 Hitt St
Columbia, MO 65212-0001 - Phone
- (573) 882-2272
- Fax
- (573) 884-5179
- NPI assigned
- Mar 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 036-165645 | IL | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 2019025439 | MO | Primary |
Addresses
Primary practice location
1021 Hitt St
Columbia, MO 65212-0001
Mailing address
1620 W Harrison St
Chicago, IL 60612-3801
Phone (312) 942-6106
Other practice location 1
1620 W Harrison St
Chicago, IL 60612-3801
Phone (312) 942-6106
Other practice location 2
2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-3242
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUDOCREFERRAL@direct.health.missouri.edu | Direct | Curators of the University of Missouri |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-165645 | IL | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Group | Pediatrics | Current | Accepting new patients |
Locations
75 Remittance Dr
Dept 1611
Chicago, IL 60675
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200
Organizations & group practices 1
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": "1364428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1831432756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 W HARRISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123801",
"telephone_number": "312-942-6106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 HITT ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652120001",
"telephone_number": "573-882-2272",
"fax_number": "573-884-5179"
}
],
"practiceLocations": [
{
"address_1": "1620 W Harrison St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606123801",
"country_code": "US",
"telephone_number": "312-942-6106",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2160 S 1st Ave",
"address_purpose": "LOCATION",
"city": "Maywood",
"state": "IL",
"postal_code": "601533328",
"country_code": "US",
"telephone_number": "708-216-3242",
"fax_number": "708-216-3375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FRIEDMAN",
"first_name": "SAMANTHA",
"middle_name": "DAWN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-28",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "IL",
"license": "036-165645",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "MO",
"license": "2019025439",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
"affiliation": "Y",
"endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
"affiliationName": "Curators of the University of Missouri",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct",
"address_1": "1021 Hitt St",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652120001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.