Jennifer L Samuel, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1263 Issued in AZ

Practice address

940 N Switzer Cyn Dr
#101
Flagstaff, AZ 86001-4852

Phone

(928) 774-7949

Fax

(928) 774-7207

NPI assigned

Oct 25, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2001

Medicare assignment

May accept Medicare assignment

Group practices

Flagstaff Eye Care PLLCGroup PAC ID 1850315623, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Flagstaff Eye Care PLLC

  • Optometrist
  • Flagstaff, AZ
  • NPI 1780711317
  Medicare reassignment Care Compare group NPD
• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Tonalea, AZ
  • NPI 1740359108
  NPD (past)
• Northern Arizona Optometry, PLLC

  • Optometrist
  • Flagstaff, AZ
  • NPI 1326587577
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1891785564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 N SWITZER CYN DR",
            "address_2": "#101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014852",
            "telephone_number": "928-774-7949",
            "fax_number": "928-774-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 N SWITZER CYN DR",
            "address_2": "#101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014852",
            "telephone_number": "928-774-7949",
            "fax_number": "928-774-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790677",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "48524047",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "D00087920",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cora F Salvino, MD
• Sam'S Club Optical
• Sams West Inc
• James Logan Samsel, M.S. CF-SLP
• Christine Samuel-Nakamura
• Amanda Sanchez
• Jasmyn Rachel Sanchez
• Eric D Sanders, DC
• Anthony E Sandoval, MD
• Sandra J. Brim, PH.D., P.C.

• Optometrist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.