Individual provider Active NPI

Samantha Sumara

  • Physical Therapist
  • Medford, NJ
National Provider Identifier
1932643186
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01688300 Issued in NJ
Practice address
176 Route 70
Suite 10
Medford, NJ 08055-8704
Phone
(609) 714-7733
Fax
(609) 714-7750
NPI assigned
Dec 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01688300 NJ Primary

Addresses

Primary practice location

176 Route 70
Suite 10
Medford, NJ 08055-8704

Mailing address

4175 Veterans Memorial Hwy
Suite 202
Ronkonkoma, NY 11779-7639
Phone (631) 580-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist Past Accepting new patients
Star Physical Therapy P.a. Past Accepting new patients

Organizations & group practices 2

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": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1932643186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 202",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797639",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 ROUTE 70",
            "address_2": "SUITE 10",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558704",
            "telephone_number": "609-714-7733",
            "fax_number": "609-714-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMARA",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01688300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.