Individual provider Active NPI

Samuel Milbin, MD

  • Pediatrics Physician
  • Olney, MD
National Provider Identifier
1831756485
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0093993 Issued in MD
Practice address
18111 Prince Philip Dr Ste 311
Olney, MD 20832-1508
Phone
(301) 774-4100
Fax
(301) 774-7648
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X LP04564 RI
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X D0093993 MD Primary

Addresses

Primary practice location

18111 Prince Philip Dr Ste 311
Olney, MD 20832-1508

Mailing address

18111 Prince Philip Dr Ste 311
Olney, MD 20832-1508
Phone (301) 774-4100

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-8805

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20230914000178 MD Practitioner - Pediatric Medicine 9830422922 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0093993MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 21, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 21, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Single Specialty Current Accepting new patients
Olney Pediatrics PA Single Specialty CurrentSince Jun 5, 2022 Accepting new patients
Luminis Health Anne Arundel Medical Center, Inc. Past Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

18111 Prince Philip Dr
Ste 311
Olney, MD 20832
Phone (301) 774-0231

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

Interoperability endpoints

  • Direct secure messaging: smilbin1030945@direct.umm.edu

Organizations & group practices 6

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": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1831756485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR STE 311",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321508",
            "telephone_number": "301-774-4100",
            "fax_number": "301-774-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR STE 311",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321508",
            "telephone_number": "301-774-4100",
            "fax_number": "301-774-7648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-8805",
            "fax_number": "401-444-2988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILBIN",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP04564",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0093993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "593 Eddy St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029034923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.