Individual provider Active NPI

Samantha D Brown, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1902977382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007830 Issued in NY
Practice address
Weiler - Dept. of Medicine
1825 Eastchester Road
Bronx, NY 10461
Phone
(718) 904-2400
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007830 NY Primary

Addresses

Primary practice location

Weiler - Dept. of Medicine
1825 Eastchester Road
Bronx, NY 10461

Mailing address

11136 Witthoff Ave
Queens Village, NY 11429-1956
Phone (718) 904-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000010 NY Practitioner - Physician Assistant 2567650005 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of Astoria PLLCGroup PAC ID 4981874641, 11 clinicians
Excel Urgent Care of NHP PLLCGroup PAC ID 1658517883, 15 clinicians

Practice addresses (Care Compare)

15740 Crossbay Blvd
Howard Beach, NY 11414-2747
Phone (917) 300-6969

900 Hillside Ave
New Hyde Park, NY 11040-2522
Phone (516) 519-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007830NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center CurrentSince Sep 23, 2010 Accepting new patients
Throgs Neck Urgent Medical Care PLLC Current Accepting new patients
Brookdale Hospital Medical Center Past Accepting new patients

Locations

1235 Linden Blvd
Fl 1
Brooklyn, NY 11212
Phone (718) 975-8368

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

Organizations & group practices 6

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902977382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11136 WITTHOFF AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291956",
            "telephone_number": "718-904-2400",
            "fax_number": "718-904-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEILER - DEPT. OF MEDICINE",
            "address_2": "1825 EASTCHESTER ROAD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-904-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SAMANTHA",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.