Individual provider Active NPI

Samantha Rai, MD

  • Family Medicine Physician
  • Mount Kisco, NY
National Provider Identifier
1871655696
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
224508-1 Issued in NY
Practice address
30 W Main St
Open Door Family Medical Centers, Inc.
Mount Kisco, NY 10549-1910
Phone
(914) 666-3272
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 224508-1 NY Primary

Addresses

Primary practice location

30 W Main St
Open Door Family Medical Centers, Inc.
Mount Kisco, NY 10549-1910

Mailing address

165 Main St
Open Door Family Medical Centers, Inc.
Ossining, NY 10562-4702
Phone (914) 941-1263

Other identifiers 1

IdentifierTypeStateIssuer
03288222MedicaidNY

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
I20161212000923 NY Practitioner - Family Practice 8921273509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 N Broadway
Sleepy Hollow, NY 10591-2370
Phone (914) 632-2737

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224508-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center Inc Current Accepting new patients

Locations

30 W Main St
Mount Kisco, NY 10549
Phone (914) 666-3272

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA
  • Direct secure messaging: samantha.rai@odfmc.eclinicaldirectplus.com

Organizations & group practices 1

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1871655696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491910",
            "telephone_number": "914-666-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAI",
        "first_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "224508-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03288222",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.