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DR. SHELBY KEVIN SAMUEL M.D.
NPI 1114947157
Internal Medicine - Gastroenterology in Brooklyn, NY

Active since July 20, 2006PECOS EnrolledAccepts Medicare Assignment
200 BROOKLYN AVE, BROOKLYN, NY 11213(718) 498-7888(718) 604-7890 Get Directions Write a Review

NPPES record last updated: February 10, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Shelby Kevin Samuel M.d. NPPES

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

DR. SHELBY KEVIN SAMUEL M.D. (NPI 1114947157) is an individual gastroenterology provider in Brooklyn, New York, licensed in New York (176352) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of State University Of New York Downstate Medical Center (1986).

NPPES Registry Identity

NPI1114947157
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. SHELBY KEVIN SAMUELCredential: M.D.
Location Address200 BROOKLYN AVEBrooklyn, NY 11213-1908
Mailing AddressPo Box 391White Plains, NY 10602-0391 · (718) 498-7888 · Fax (718) 604-7890
Phone(718) 498-7888
Fax(718) 604-7890
Sole ProprietorYes
Medical School CMSState University Of New York Downstate Medical CenterGraduated 1986
Enumeration DateJuly 20, 2006
Last NPPES UpdateFebruary 10, 2012
✔ NPI 1114947157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in NY · 176352
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
200 BROOKLYN AVE, Brooklyn, NY 11213
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Other Identifiers 3

Medicaid01448966NY
Medicare UPINF61761NY
Medicare ID-Type Unspecified67H042NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shelby Kevin Samuel M.d. 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 ID2567374184
PECOS Enrollment IDI20031103000392
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.

Medicare Billing Reassignment

Medicare enrollment records show Shelby Samuel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Blue Green Horizons Office Based Surgery PLLC
Same address
Multi-Specialty
200 BROOKLYN AVE
Brooklyn, NY 11213
  • Reassigned Medicare billing, New York enrollment
  • 2 clinicians in this Medicare group
NPI 1073835641 (718) 498-7888

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
31 services31 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
17 services16 patients
Diagnostic exam of large bowel using a flexible endoscope 45378
This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11213 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

Other Providers at the Same Location NPPES 2

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

BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC
Clinic/Center (Multi-Specialty)
200 BROOKLYN AVE
BROOKLYN, NY 11213
Kings County (718) 498-7888
BROOKLYN AVENUE MEDICAL PLLC
Anesthesiology
200 BROOKLYN AVE
BROOKLYN, NY 11213
Kings County (718) 498-7888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelby Samuel's NPI number?

The NPI number for Shelby Samuel is 1114947157. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Shelby Samuel located?

Shelby Samuel practices at 200 Brooklyn Ave, Brooklyn, NY 11213. The listed phone number is (718) 498-7888.

What is Shelby Samuel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Shelby Samuel enrolled in Medicare?

Yes. Shelby Samuel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Shelby Samuel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shelby Samuel reassigns Medicare benefits to Blue Green Horizons Office Based Surgery PLLC (Brooklyn, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shelby Samuel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shelby Samuel was last updated on February 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.