SAMUEL SHATKIN JR MD PLLC , NPI 1841436995 — SAMUEL SHATKIN JR MD PLLC in AMHERST (NY)

NPI 1841436995

11+ Years Experience Organization

SAMUEL SHATKIN JR MD PLLC

Other organization name: SAMUEL SHATKIN JR MD PLLC. Name type code: 3 - doing business as (d/b/ a) name.

12/19/2008
PROVIDER ENUMERATION DATE
04/15/2009
LAST UPDATE DATE
1841436995
NPI NUMBER

About SAMUEL SHATKIN JR MD PLLC

SAMUEL SHATKIN JR MD PLLC is a provider established in AMHERST, NY. The NPI number of SAMUEL SHATKIN JR MD PLLC is 1841436995 and was assigned on 12/19/2008. The practitioners primary taxonomy code is: 261QA1903X with license number: 168299 NY .

Mailing address

  • City: AMHERST
  • State: NY
  • Postal code: 142264927
  • Phone: 7168391700
  • Fax: 7168391701
  • Address: 2500 KENSINGTON AVE

Primary Practice Address

  • Region : AMHERST, NY
  • NPI : 1841436995
  • Phone : 7168391700
  • Fax : 7168391701
  • Postalcode : 14226
  • Address : 2500 KENSINGTON AVENUE

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QA1903X
  • License number: 168299
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • SAMUEL SHATKIN JR MD PLLC
  • Address : 2500 KENSINGTON AVENUE
  • Region : AMHERST, NY
  • NPI : 1841436995
  • Phone : 7168391700
  • Fax : 7168391701
  • Postalcode : 14226

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 7168391700
  • Title or position : DOCTOR
  • Credentials : M.D.

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address2500 KENSINGTON AVENUE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameAMHERST
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code14226
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7168391700
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7168391701
The fax number associated with the location address of the provider being identified.
NPI1841436995
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QA1903X
Provider Enumeration Date12/19/2008
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/15/2009
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)SAMUEL SHATKIN JR MD PLLC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameSAMUEL SHATKIN JR MD PLLC
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address2500 KENSINGTON AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameAMHERST
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code142264927
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7168391700
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number7168391701
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameSHATKIN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameSAMUEL
The first name of the authorized official
Authorized Official Title or PositionDOCTOR
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextM.D.
Authorized Official Credential Text
Authorized Official Telephone Number7168391700
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QA1903X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Provider License Number 1168299
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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