David P Samuels, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

049521 Issued in GA

Practice address

19 Lester Rd
Statesboro, GA 30458-2119

Phone

(912) 662-6501

Fax

(912) 681-1012

NPI assigned

Mar 14, 2007

Last updated

Apr 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, FL2 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

Specialty

Psychiatry

Education

Kansas City University of Physicians and Surgeons, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: david.samuels.1@18773.direct.athenahealth.com
• Direct secure messaging: david.samuels.1@8042.direct.athenahealth.com
• Direct secure messaging: david.samuels@healthiealerts.org
• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857

  Single Specialty

  Medicare reassignment Care Compare group NPD
• DPS Health and Wellness

  • Psychiatry Physician
  • Statesboro, GA
  • NPI 1073981999
  Authorized official Same address or phone
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD
• Center of Revitalizing Psychiatry, P.C.

  • Psychiatry Physician
  • Rochelle Park, NJ
  • NPI 1356497960

  Single Specialty

  NPD
• Hospital Authority of Jenkins County

  • Critical Access Hospital
  • Millen, GA
  • NPI 1760452098
  NPD (past)
• Center of Revitalizing Psychiatry PC

  • Adult Mental Health Clinic/Center
  • Sarasota, FL
  • NPI 1538572854
  NPD (past)
• Guardian Eldercare PC

  • Community/Behavioral Health Agency
  • Hackensack, NJ
  • NPI 1194888008

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1942333158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LESTER RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582119",
            "telephone_number": "912-662-6501",
            "fax_number": "912-681-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 LESTER RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582119",
            "telephone_number": "912-662-6501",
            "fax_number": "912-681-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS14765",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "049521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000895177A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Sack, PA-C
• Safe to Shore Counseling
• Neil Saha
• Gwyn Salguero
• Jada Sams
• Courtney Nicole Sanderlin, CRNA
• Melissa Sands
• Sapelo Counseling Center
• Anna Grace Sapp
• Catherine Sapp, CPNP

• Psychiatry Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.