Active NPI
Samuel M Andelman, MD
- Specialist
- Alamosa, CO
National Provider Identifier
1992745715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 40629
- Practice address
- 106 Blanca Ave
Alamosa, CO 81101-2340 - Phone
- (877) 662-4044
- NPI assigned
- Jun 8, 2006
- Last updated
- Oct 4, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 40629 | CO | Primary |
Addresses
Primary practice location
106 Blanca Ave
Alamosa, CO 81101-2340
Mailing address
PO Box 7693
Loveland, CO 80537-0693
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35007508 | Medicaid | CO | |
| P00061125 | Other | CO | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| 40629 | CO | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Diagnostic Medicine, LLC | Past | Accepting new patients | |
| Southern Colorado Imaging Associates, PC | Specialist | Past | Accepting new patients |
| Advanced Radiology P a | Past | Accepting new patients | |
| Advanced Radiology P a | Past | Accepting new patients |
Organizations & group practices 4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1992745715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7693",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805370693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 BLANCA AVE",
"city": "ALAMOSA",
"state": "CO",
"postal_code": "811012340",
"telephone_number": "877-662-4044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDELMAN",
"first_name": "SAMUEL",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "40629",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35007508",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00061125",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alamosa, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.