SAMARITAN MEDICAL PRACTICE, PC
NPI 1124202619
Surgery in Watertown, NY
About Samaritan Medical Practice, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMARITAN MEDICAL PRACTICE, PC (NPI 1124202619) is a healthcare organization registered as a surgery in Watertown, New York and active in the NPI registry since December 2007. The organization holds a CLIA Certificate of Compliance certificate valid through March 26, 2027 and lists Mario Victoria, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samaritan Medical Practice, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
26Medicare enrollment records show 26 clinicians reassign Medicare billing to Samaritan Medical Practice, PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 15 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 9
Nearest to this location (20)
See all 26Watertown, NY 13601
Gardner, MA 01440
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 33D0950347
Samaritan Medical Practice, Pulmonology · Watertown, NYFrequently 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 Samaritan Medical Practice, PC's NPI number?
The NPI number for Samaritan Medical Practice, PC is 1124202619. It was assigned to this organization in the NPPES registry on December 20, 2007.
Where is Samaritan Medical Practice, PC located?
Samaritan Medical Practice, PC is located at 826 Washington St, Watertown, NY 13601. The listed phone number is (315) 788-1751.
What is Samaritan Medical Practice, PC's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Samaritan Medical Practice, PC enrolled in Medicare?
Yes. Samaritan Medical Practice, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Samaritan Medical Practice, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 26 clinicians in 9 Medicare specialties reassign their Medicare billing to Samaritan Medical Practice, PC. A 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 the clinician's services. The largest specialties are Orthopedic Surgery (8), Cardiovascular Disease (Cardiology) (5) and General Surgery (4). Of these, 3 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Samaritan Medical Practice, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 33D0950347) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Samaritan Medical Practice, PC was last updated on November 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Samaritan Medical Practice, Pc · NPI 1124202619
Surgery organization in Watertown, New York. Organization record, active in the CMS NPPES registry since December 20, 2007.
## Identity
- **NPI:** 1124202619 (Entity type: Organization)
- **Enumerated:** December 20, 2007
- **Primary specialty:** Surgery · taxonomy 208600000X
- **Organization subpart:** No
- **Authorized official:** Mario Victoria, PRESIDENT
## Practice location
- **Address:** 826 WASHINGTON ST, Watertown, NY 13601-4063
- **Phone:** (315) 788-1751
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 26 clinicians in 9 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Orthopedic Surgery (8), Cardiovascular Disease (Cardiology) (5), General Surgery (4); 3 practice at this address and 15 within 10 miles; [full list](https://npiprofile.com/npi/1124202619/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 21, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124202619) · Data from the CMS NPPES public registry.