Individual provider Active NPI

Michael A Samach, M.D.

  • Gastroenterology Physician
  • Morristown, NJ
National Provider Identifier
1861508566
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA03450100 Issued in NJ
Practice address
101 Madison Ave
Suite 100
Morristown, NJ 07960-7357
Phone
(973) 455-0404
Fax
(973) 540-8788
NPI assigned
Aug 22, 2006
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 34501 NJ
Gastroenterology Physician 207RG0100X 25MA03450100 NJ Primary

Addresses

Primary practice location

101 Madison Ave
Suite 100
Morristown, NJ 07960-7357

Mailing address

101 Madison Ave
Suite 100
Morristown, NJ 07960-7357
Phone (973) 455-0404

Other identifiers 1

IdentifierTypeStateIssuer
0519103MedicaidNJ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34501NJMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1861508566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MADISON AVE",
            "address_2": "SUITE 100",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607357",
            "telephone_number": "973-455-0404",
            "fax_number": "973-540-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MADISON AVE",
            "address_2": "SUITE 100",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607357",
            "telephone_number": "973-455-0404",
            "fax_number": "973-540-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMACH",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "34501",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA03450100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0519103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.