Individual provider Active NPI

Samuel Friedman, M.D.

  • Hematology & Oncology Physician
  • Tamuning, GU
National Provider Identifier
1891747069
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
M001476 Issued in GU
Practice address
Guam Medical Plaza
633 Gov. Carlos Camacho Rd. Ste B5
Tamuning, GU 96913-3194
Phone
(671) 647-4656
Fax
(671) 647-4660
NPI assigned
May 16, 2006
Last updated
Apr 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X M001476 GU Primary
Hematology & Oncology Physician 207RH0003X MD 00033258 WA
Hematology & Oncology Physician 207RH0003X G20360 CA

Addresses

Primary practice location

Guam Medical Plaza
633 Gov. Carlos Camacho Rd. Ste B5
Tamuning, GU 96913-3194

Mailing address

Guam Medical Plaza
633 Gov. Carlos Camacho Rd. Ste B5
Tamuning, GU 96913-3194
Phone (671) 647-4656

Other identifiers 1

IdentifierTypeStateIssuer
F-0096744MedicaidGU

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20120713000223 GU Practitioner - Hematology/OncologyPractitioner - Allergy/ImmunologyPractitioner - Internal MedicinePractitioner - RheumatologyPractitioner - Medical Oncology 1052347317 Reassigns benefits to 1 organization
Practice locations: Tamuning, GU

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114280NYMDMental Health Counselor
G20360CAMDHematology & Oncology Physician
MD 00033258WAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westpac Hematology & Oncology Center Inc Hematology & Oncology CurrentSince Dec 28, 2018 Accepting new patients

Locations

633 Gov Carlos G Camacho Rd
Ste B5
Tamuning, GU 96913
Phone (671) 647-4656

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, 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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1891747069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUAM MEDICAL PLAZA",
            "address_2": "633 GOV. CARLOS CAMACHO RD. STE B5",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133194",
            "telephone_number": "671-647-4656",
            "fax_number": "671-647-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GUAM MEDICAL PLAZA",
            "address_2": "633 GOV. CARLOS CAMACHO RD. STE B5",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133194",
            "telephone_number": "671-647-4656",
            "fax_number": "671-647-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GU",
            "license": "M001476",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD 00033258",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G20360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F-0096744",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.