Active NPI
Michael G Sampson, M.D.
- Pulmonary Disease Physician
- Riverhead, NY
National Provider Identifier
1982788428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 146289-1
- Practice address
- 185 Old Country Rd
Suite 3
Riverhead, NY 11901-2121 - Phone
- (631) 727-2523
- Fax
- (631) 727-7353
- NPI assigned
- Oct 24, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 146289-1 | NY | Primary |
Addresses
Primary practice location
185 Old Country Rd
Suite 3
Riverhead, NY 11901-2121
Mailing address
185 Old Country Rd
Suite 3
Riverhead, NY 11901-2121
Phone (631) 727-2523
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00600913 | Medicaid | NY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146289-1 | NY | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982788428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 OLD COUNTRY RD",
"address_2": "SUITE 3",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012121",
"telephone_number": "631-727-2523",
"fax_number": "631-727-7353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 OLD COUNTRY RD",
"address_2": "SUITE 3",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012121",
"telephone_number": "631-727-2523",
"fax_number": "631-727-7353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "MICHAEL",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "146289-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00600913",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.