Individual provider Active NPI

Samwiri Mukasa

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1982014817
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
SN223634 Issued in OH
Practice address
2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone
(513) 585-0855
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X SN223634 OH Primary

Addresses

Primary practice location

2139 Auburn Ave
Cincinnati, OH 45219-2906

Mailing address

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-0855

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DC, MD, VA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20190821002701 PA Practitioner - Diagnostic Radiology 2961730437 Reassigns benefits to 1 organization
I20200715003461 DC Practitioner - Diagnostic Radiology 2961730437 Reassigns benefits to 1 organization
I20201027001932 MD Practitioner - Diagnostic Radiology 2961730437 Reassigns benefits to 1 organization
I20201102000878 VA Practitioner - Diagnostic Radiology 2961730437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

10810 Connecticut Ave
Kensington, MD 20895-2138
Phone (301) 929-7100

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

1396 Piccard Dr
Rockville, MD 20850-4302
Phone (301) 548-5700

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000

1890 Metro Ctr Dr
Reston, VA 20190-5286
Phone (703) 709-1500

201 N Washington St
Falls Church, VA 22046-4518
Phone (703) 237-4000

5100 Auth Way
Suitland, MD 20746-4207
Phone (301) 702-5000

5620 Ager Rd
Hyattsville, MD 20782-3729
Phone (240) 906-6600

5999 Burke Commons Rd
Burke, VA 22015-2880
Phone (703) 249-7700

6104 Old Branch Ave
Temple Hills, MD 20748-2518
Phone (301) 702-6100

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

6551 Loisdale CT
Springfield, VA 22150-1828
Phone (703) 922-1000

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SN223634OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine CurrentSince Jul 13, 2020 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 3, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jul 13, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 1, 2020 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 7

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1982014817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-585-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-585-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKASA",
        "first_name": "SAMWIRI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "SN223634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "10810 Connecticut Ave",
            "city": "Kensington",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208952138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.