Individual provider Active NPI

Samantha Ganz, M.D

  • Emergency Medicine Physician
  • Jamaica, NY
National Provider Identifier
1871027672
Registry record updated Dec 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
302005 Issued in NY
Practice address
82-68 164TH Street
Jamaica, NY 11432
Phone
(718) 883-3070
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 302005 NY Primary

Addresses

Primary practice location

82-68 164TH Street
Jamaica, NY 11432

Mailing address

82-68 164TH St
Jamaica, NY 11432-1121
Phone (718) 883-3070

Other practice location 1

1 Gustave L Levy Pl
Box 1149
New York, NY 10029-6504
Phone (212) 824-8069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220429000351 NY Practitioner - Emergency Medicine 7315285491 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302005NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Port Emergency Medical Services, P.C. Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Siena Emergency Medical Services, P.C. Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Island Emergency Medical Services, P.C. Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients

Locations

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670630400000",
    "number": "1871027672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-68 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321121",
            "telephone_number": "718-883-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82-68 164TH STREET",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-883-3070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_2": "Box 1149",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-824-8069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANZ",
        "first_name": "SAMANTHA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2022-12-10",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "302005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.