JONMICHAEL SAMSEL DO
NPI 1003492653
Dermatology in Kingsport, TN

Q: What is Jonmichael Samsel's NPI number?

The NPI number for Jonmichael Samsel is 1003492653. It was assigned to this individual provider in the NPPES registry on March 23, 2021.

Q: What is Jonmichael Samsel's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jonmichael Samsel was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 23, 2021PECOS EnrolledAccepts Medicare Assignment

2300 W STONE DR, KINGSPORT, TN 37660(423) 246-4961(423) 245-3136 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 8, 2022, Apr 7, 2021, Mar 23, 2021 (3 updates tracked since 2021).

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About Jonmichael Samsel Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONMICHAEL SAMSEL DO (NPI 1003492653) is an individual dermatology provider in Kingsport, Tennessee, licensed in Tennessee (6253) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Johnson City, and is a graduate of Edward Via Col Of Osteo Medicine-virginia Campus (2021).

NPPES Registry Identity

NPI1003492653

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameJONMICHAEL SAMSELCredential: DO

Location Address2300 W STONE DRKingsport, TN 37660-2360

Mailing Address2300 W Stone DrKingsport, TN 37660-2360 · (423) 246-4961 · Fax (423) 245-3136

Phone(423) 246-4961

Fax(423) 245-3136

Sole ProprietorNo

Medical School CMSEdward Via Col Of Osteo Medicine-virginia CampusGraduated 2021

Enumeration DateMarch 23, 2021

Last NPPES UpdateAugust 1, 20253 updates tracked since enumeration

NPPES CertifiedAugust 1, 2025

✔ NPI 1003492653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in TN · 6253

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 0102207529 (VA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2300 W STONE DR, Kingsport, TN 37660

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Secondary Practice Location 1

Location 12885 Boones Creek RdJohnson City, TN 37615-8002 · Phone (423) 928-9014 · Fax (423) 245-3136

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jonmichael Samsel Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365843828

PECOS Enrollment IDI20250605002161

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KYLE PHILLIP RADACK M.D.

Dermatology