Individual provider Active NPI

Samuel Tezeh Munoh

  • Home Health Aide
  • Bladensburg, MD
National Provider Identifier
1902457377
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA14667 Issued in DC
Practice address
3801 Kenilworth Ave Apt 302E
Bladensburg, MD 20710-2131
Phone
(301) 851-9239
NPI assigned
Sep 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA14667 DC Primary

Addresses

Primary practice location

3801 Kenilworth Ave Apt 302E
Bladensburg, MD 20710-2131

Mailing address

3801 Kenilworth Ave Apt 302E
Bladensburg, MD 20710-2131
Phone (301) 851-9239

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HHA14667DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1902457377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KENILWORTH AVE APT 302E",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207102131",
            "telephone_number": "301-851-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KENILWORTH AVE APT 302E",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207102131",
            "telephone_number": "301-851-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOH",
        "first_name": "SAMUEL",
        "middle_name": "TEZEH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA14667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bladensburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.