Individual provider Active NPI

Tarig A Samarkandy, MD

  • Surgery Physician
  • Stockton, CA
National Provider Identifier
1942443874
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A113233 Issued in CA
Practice address
2545 W Hammer LN
Stockton, CA 95209-2839
Phone
(209) 957-7050
NPI assigned
Apr 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A113233 CA Primary

Addresses

Primary practice location

2545 W Hammer LN
Stockton, CA 95209-2839

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140808002057 CA Practitioner - General Surgery 3274750534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2200 Orchard Pkwy
Suite 102
Tracy, CA 95377-7346
Phone (209) 830-4060

2505 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2545 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2800 L St
Sacramento, CA 95816-5616

441 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 830-4062

445 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 524-1211

447 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 830-4062

473 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 833-3320

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

815 Court St
Jackson, CA 95642-2154

918 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 366-2001

924 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 334-2590

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)24
Upper gastrointestinal (GI) endoscopy for acid reflux34
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113233CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lodi Memorial Hospital Association Inc Past Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Regents of the Univ of Ca Surgery Past Accepting new patients
St. Joseph'S Hospital, Yonkers Past Accepting new patients
County of San Joaquin Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tsamarkandy235517@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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 5

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1942443874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "209-957-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARKANDY",
        "first_name": "TARIG",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A113233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.