Organization Active NPI

Soundview Medical Physician PC

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1851499206
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200002 Issued in NY
Legal business name
SOUNDVIEW MEDICAL PHYSICIAN PC
Practice address
609 Soundview Ave
Bronx, NY 10473-2945
Phone
(718) 991-7330
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Authorized official

Name
Nedal Samarneh, MDNPI 1336250927
Title
President
Phone
(718) 991-7330

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 200002 NY Primary

Addresses

Primary practice location

609 Soundview Ave
Bronx, NY 10473-2945

Mailing address

609 Soundview Ave
Bronx, NY 10473-2945
Phone (718) 991-7330

Other identifiers 2

IdentifierTypeStateIssuer
03425156MedicaidNY
01642479MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000951 NY Part B Supplier - Clinic/Group Practice 9335132273 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1021127Soundview Medical Physician PC609 Soundview Ave, Bronx, NY 10473Certificate of waiverJan 12, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1851499206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SOUNDVIEW AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732945",
            "telephone_number": "718-991-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SOUNDVIEW AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732945",
            "telephone_number": "718-991-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUNDVIEW MEDICAL PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "SAMARNEH",
        "authorized_official_first_name": "NEDAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-991-7330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "200002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03425156",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01642479",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.