Individual provider Active NPI

Samuel Turner Carrell, MD/PHD

  • Neurology Physician
  • Henrico, VA
National Provider Identifier
1922595545
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101281505 Issued in VA
Practice address
11958 W Broad St
Henrico, VA 23233-1007
Phone
(804) 360-4669
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 0101281505 VA
Neurology Physician 2084N0400X 0101281505 VA Primary

Addresses

Primary practice location

11958 W Broad St
Henrico, VA 23233-1007

Mailing address

10816 Weather Vane Rd
Henrico, VA 23238-4161
Phone (319) 538-5636

Other practice location 1

1000 E Broad St
Richmond, VA 23219-1930
Phone (804) 828-2467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220611000094 PA Practitioner - Neurology 4789935925 Reassigns benefits to 1 organization
I20241030003452 VA Practitioner - Neurology 4789935925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

11958 W Broad St
Henrico, VA 23233-1007
Phone (804) 364-6641

Hospital & facility affiliations

  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101281505VAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Neurology CurrentSince Jul 30, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
University of Penn-Medical Group Neurology CurrentSince Jul 1, 2022 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

11958 W Broad St
Richmond, VA 23233
Phone (804) 360-4669

1000 E Broad St
Richmond, VA 23219

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1922595545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10816 WEATHER VANE RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232384161",
            "telephone_number": "319-538-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11958 W BROAD ST",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331007",
            "telephone_number": "804-360-4669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232191930",
            "country_code": "US",
            "telephone_number": "804-828-2467",
            "fax_number": "804-628-5854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRELL",
        "first_name": "SAMUEL",
        "middle_name": "TURNER",
        "credential": "MD/PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "VA",
            "license": "0101281505",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101281505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.