Mohammad Y Samara, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36801 Issued in WI

Practice address

6540 Reflection Dr Apt 1410
San Diego, CA 92124-5143

Phone

(414) 793-0115

Fax

(414) 246-4198

NPI assigned

Aug 31, 2006

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 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Senior Medical Associates, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • San Diego, CA
  • NPI 1629253505
  Medicare reassignment NPD
• General Medicine, P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Novi, MI
  • NPI 1811945199
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1952413114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 REFLECTION DR APT 1410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921245143",
            "telephone_number": "414-793-0115",
            "fax_number": "414-246-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 REFLECTION DR APT 1410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921245143",
            "telephone_number": "414-793-0115",
            "fax_number": "414-246-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARA",
        "first_name": "MOHAMMAD",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "C171319",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "36801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WI34060001 INDIVIDUA",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000073606 GROUP",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WI3406 GROUP",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00017606 INDIVIDUAL",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32170400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Josiefin Samaniego
• Ruth Samaniego
• Antonio C Samano
• Carolina Samano, MS
• Samantha Cohen, MD, Inc.
• Kosala Samarasinghe, M.D.
• Farah Samarrai, LPCC
• Pablo R Samayoa, SUDRC
• Joseph Vincent Sambade
• Anthony Sambrano

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.