IMMACULA SAMSON
NPI 1023505955
Nurse Practitioner - Adult Health in Jamaica, NY

Q: What is Immacula Samson's NPI number?

The NPI number for Immacula Samson is 1023505955. It was assigned to this individual provider in the NPPES registry on April 17, 2018.

Q: What is Immacula Samson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Immacula Samson was last updated on June 16, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 17, 2018PECOS Enrolled

8268 164TH ST, JAMAICA, NY 11432(718) 883-3226 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2018, Apr 17, 2018 (2 updates tracked since 2018).

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About Immacula Samson NPPES

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

IMMACULA SAMSON (NPI 1023505955) is an individual adult health provider in Jamaica, New York, licensed in New York (9854779) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023505955

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameIMMACULA SAMSON

Location Address8268 164TH STJamaica, NY 11432-1121

Mailing Address46 Ashley DrValley Stream, NY 11580-2439 · (516) 943-3952

Phone(718) 883-3226

Sole ProprietorYes

Enumeration DateApril 17, 2018

Last NPPES UpdateJune 16, 20182 updates tracked since enumeration

✔ NPI 1023505955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · 9854779

8268 164TH ST, Jamaica, NY 11432

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Immacula Samson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 11432 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

$104.17 typical visit price

range $67.00 – $201.98

Typical copayment $26.04 (range $16.75 – $50.49)

Most-billed visit code 99203

Established Patient

$116.96 typical visit price

range $21.62 – $163.52

Typical copayment $29.24 (range $5.40 – $40.88)

Most-billed visit code 99214

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