Samuel Medical Care PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SAMUEL MEDICAL CARE PLLC

Practice address

125 E Central Ave
Pearl River, NY 10965-2543

Phone

(845) 920-8909

NPI assigned

Oct 31, 2024

Organization subpart

No

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

Authorized official

Name

Shwan Samuel, DO

Title

Owner

Phone

(845) 920-8909

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Kunjumon Samuel, DO, MS

  • Hospitalist Physician
  • Bronx, NY
  • NPI 1649366204
  Medicare reassignment NPD

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1902628712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652543",
            "telephone_number": "845-920-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652543",
            "telephone_number": "845-920-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "SHWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-920-8909",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose A Ruddy, ACNP
• Angela Margaret Ryan, COTA
• Christine Ryan, CCC-SLP
• Ximena Andrea Salamanca
• Sizar Samiz
• Susan Sanchez
• Sarwat Shenouda Dentist PC
• Arthur William Sauter Jr., PH.D.
• Dante Scala, DMD
• Joseph Scala, DMD

• Physical Medicine & Rehabilitation Physician in Pearl River, NY
• Providers in Pearl River, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.