Samuel R Pesin, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

ME122753 Issued in OH

Practice address

781 Crandon Blvd Apt 1103
Key Biscayne, FL 33149-2546

Phone

(419) 351-9859

NPI assigned

Feb 22, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1992770093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 CRANDON BLVD APT 1103",
            "city": "KEY BISCAYNE",
            "state": "FL",
            "postal_code": "331492546",
            "telephone_number": "419-351-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 CRANDON BLVD APT 1103",
            "city": "KEY BISCAYNE",
            "state": "FL",
            "postal_code": "331492546",
            "telephone_number": "419-351-9859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E 57th St Apt 16C",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100222861",
            "country_code": "US",
            "telephone_number": "419-351-9859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESIN",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "ME122753",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OH",
            "license": "ME122753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catalina Ortiz
• Rajendra N Pahwa, MD
• Palmer Clinic on the Key, LLC
• Armando Francisco Paz Sr., DMD
• Juan Perez Barcena, MD
• Maria Esther Piriz Campos, P.A.
• Polga Medical Group P a
• Leannys C Pollan Sanchez, RDH
• Ana Rabassa Thompson
• Patricia Rivero

• Retina Specialist (Ophthalmology) Physician in Key Biscayne, FL
• Providers in Key Biscayne, FL by specialty
• Retina Specialist (Ophthalmology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.