NPIMap

Organization Active NPI

Samuel Shatkin Jr MD PLLC

  • Ambulatory Surgical Clinic/Center
  • Amherst, NY
National Provider Identifier
1841436995
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
168299 Issued in NY
Legal business name
SAMUEL SHATKIN JR MD PLLC
Doing business as
Samuel Shatkin Jr MD pllc
Practice address
2500 Kensington Avenue
Amherst, NY 14226
Phone
(716) 839-1700
Fax
(716) 839-1701
NPI assigned
Dec 19, 2008
Last updated
Apr 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Authorized official

Name
Dr. Samuel Shatkin Jr., M.D.NPI 1134122682
Title
Doctor
Phone
(716) 839-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 168299 NY Primary

Addresses

Primary practice location

2500 Kensington Avenue
Amherst, NY 14226

Mailing address

2500 Kensington Ave
Amherst, NY 14226-4927
Phone (716) 839-1700

Other names 1

  • Samuel Shatkin Jr MD pllc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090415000201 NY Part B Supplier - Clinic/Group Practice 9931256682 Receives reassigned benefits from 1 practitioner
Practice locations: Amherst, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1841436995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 KENSINGTON AVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264927",
            "telephone_number": "716-839-1700",
            "fax_number": "716-839-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 KENSINGTON AVENUE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-1700",
            "fax_number": "716-839-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL SHATKIN JR MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "SHATKIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "716-839-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "168299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samuel Shatkin Jr MD pllc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.