Individual provider Active NPI

Samantha Christina Bacarella, PHARMD

  • Pharmacist
  • New York, NY
National Provider Identifier
1861155103
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
068387 Issued in NY
Practice address
741 Columbus Ave
New York, NY 10025-6461
Phone
(212) 316-0436
NPI assigned
Oct 13, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 068387 NY Primary

Addresses

Primary practice location

741 Columbus Ave
New York, NY 10025-6461

Mailing address

15805 Cryders LN
Whitestone, NY 11357-2704
Phone (347) 408-8512

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/a

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
068387NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of New York Inc PastSince Oct 17, 2021 Accepting new patients
Rite Aid of New York Inc PastSince Oct 17, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1861155103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15805 CRYDERS LN",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572704",
            "telephone_number": "347-408-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 COLUMBUS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256461",
            "telephone_number": "212-316-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACARELLA",
        "first_name": "SAMANTHA",
        "middle_name": "CHRISTINA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "068387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/a",
            "affiliation": "N",
            "address_1": "741 Columbus Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100256461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.