The Samra Group, LLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

THE SAMRA GROUP, LLC

Practice address

300 Perrine Rd
Suite 331
Old Bridge, NJ 08857-2871

Phone

(732) 727-8800

Fax

(732) 727-0955

NPI assigned

Oct 3, 2006

Last updated

Apr 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Munisa Nazirova

Title

Office Manager

Phone

(732) 739-2100

Specialties & licenses 1

Addresses

Other identifiers 5

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raja Barakat, MD

  • Pediatric Adolescent Medicine Physician
  • Holmdel, NJ
  • NPI 1174586341
  NPD (past)
• Ewa Grochowalska, MD

  • Pediatrics Physician
  • Old Bridge, NJ
  • NPI 1659572311
  NPD (past)
• Zehra Siddiqui, D.O.

  • Pediatric Adolescent Medicine Physician
  • Old Bridge, NJ
  • NPI 1578740197
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1992899850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PERRINE RD",
            "address_2": "SUITE 331",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572871",
            "telephone_number": "732-727-8800",
            "fax_number": "732-727-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PERRINE RD",
            "address_2": "SUITE 331",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572871",
            "telephone_number": "732-727-8800",
            "fax_number": "732-727-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SAMRA GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "NAZIROVA",
        "authorized_official_first_name": "MUNISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-739-2100"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152081",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152099",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3155501",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480304",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0086720",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Adolescent Medicine Physician in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.