NPIMap

Individual provider Active NPI

Samuel D Critides Jr., MD

  • Neurological Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1902856503
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME150323 Issued in FL
Practice address
350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699
Phone
(850) 374-3125
Fax
(850) 226-5544
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME150323 FL Primary

Addresses

Primary practice location

350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699

Mailing address

350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699
Phone (850) 374-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, AL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140630001474 FL Practitioner - Neurosurgery 9537172622 Reassigns benefits to 1 organization
I20180130001222 GA Practitioner - Neurosurgery 9537172622 Reassigns benefits to 1 organization
I20230119000507 AL Practitioner - Neurosurgery 9537172622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samuel D Critides Jr MD PAGroup PAC ID 1759742877, 4 clinicians

Practice addresses (Care Compare)

102 Doctors Dr
Dothan, AL 36301-2911
Phone (334) 793-6573

350 G Racetrack Rd NW
Homeport Neurosurgery and Spine
Fort Walton Beach, FL 32547-1699
Phone (850) 374-3125

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion181
Laminectomy or laminotomy (partial removal of spine bones)49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME150323FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Current Accepting new patients
Samuel D. Critides, Jr., M.D., P.a. Neurological Surgery CurrentSince Apr 22, 2023 Accepting new patients
Cooperative Healthcare Services Inc CurrentSince Jan 1, 2023 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Houston County Healthcare Authority Neurological Surgery CurrentSince Dec 23, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Dalton Cardiology, P.C. Past Accepting new patients
Hamilton Medical Center, Inc. Past Accepting new patients

Locations

102 Doctors Dr
Dothan, AL 36301
Phone (334) 793-8804

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

155 Crystal Beach Dr
Ste 200
Destin, FL 32541
Phone (850) 353-2055

350G Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 374-3125

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

2000 Dan Proctor Dr
Saint Marys, GA 31558
Phone (912) 576-6160

Interoperability endpoints

  • Direct secure messaging: samuel.critides.1@29270.direct.athenahealth.com
  • Direct secure messaging: samuel.critides@hca5.eclinicaldirectplus.com

Organizations & group practices 10

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1902856503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350G RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471699",
            "telephone_number": "850-374-3125",
            "fax_number": "850-226-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350G RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471699",
            "telephone_number": "850-374-3125",
            "fax_number": "850-226-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITIDES",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME150323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.