Individual provider Active NPI

Samuel F Sears Jr., PHD

  • Psychologist
  • Greenville, NC
National Provider Identifier
1902811565
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3500 Issued in NC
Practice address
115 Heart Dr
Greenville, NC 27834-8982
Phone
(252) 744-4400
Fax
(252) 744-3987
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5538 FL
Psychologist 103T00000X 3500 NC Primary

Addresses

Primary practice location

115 Heart Dr
Greenville, NC 27834-8982

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other identifiers 3

IdentifierTypeStateIssuer
047MAOtherNCBCBS NC
211932300MedicaidFL
6001068MedicaidNC

Other names 1

  • Samuel Frazer Sears Jr. Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssears21333@direct.ecuhealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000751 NC Practitioner - Clinical Psychologist 8123193968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians

Practice addresses (Care Compare)

600 Moye Blvd
Greenville, NC 27834-4300
Phone (252) 744-4611

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY5538FLMDPsychologist
3500NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Jul 1, 2008 Accepting new patients
East Carolina University Current Accepting new patients
Florida Health Professions Association, Inc. Past Accepting new patients

Locations

115 Heart Dr
Greenville, NC 27834
Phone (252) 744-4400

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

Organizations & group practices 3

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1902811565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HEART DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348982",
            "telephone_number": "252-744-4400",
            "fax_number": "252-744-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS",
        "first_name": "SAMUEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5538",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "047MA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211932300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001068",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssears21333@direct.ecuhealth.com",
            "affiliation": "N",
            "endpointDescription": "ECU Physicians",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "115 Heart Dr",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278348982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "SEARS",
            "middle_name": "FRAZER",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.