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SAMARITAN MEDICAL PRACTICE, PC
NPI 1124202619
Surgery in Watertown, NY

Active since December 20, 2007CLIA 33D0950347 · Certificate of Compliance
826 WASHINGTON ST, WATERTOWN, NY 13601(315) 788-1751 Get Directions Write a Review

NPPES record last updated: November 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1124202619
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameSAMARITAN MEDICAL PRACTICE, PC
Location Address826 WASHINGTON STWatertown, NY 13601-4063
Mailing Address830 Washington StWatertown, NY 13601-4034 · (315) 785-4570
Phone(315) 788-1751
Organization SubpartNo
Authorized OfficialMario VictoriaPresident · (315) 785-4570
Enumeration DateDecember 20, 2007
Last NPPES UpdateNovember 21, 2022
NPPES CertifiedNovember 21, 2022
✔ NPI 1124202619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
826 WASHINGTON ST, Watertown, NY 13601
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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, NY
Active · expires Mar 26, 2027
CLIA Number33D0950347
Laboratory TypePhysician Office
Certificate Effective DateFebruary 22, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. David Rechlin
Laboratory Phone(315) 786-0254
Laboratory LocationSamaritan Medical Practice, Pulmonology19320 Us Route 11, Watertown, NY 13601
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 15

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

BRAXTON L HILLERMAN MD
Otolaryngology
826 WASHINGTON ST, SUITE 204
WATERTOWN, NY 13601
Jefferson County (315) 788-1751
NORMAN WEIR MD
Otolaryngology
826 WASHINGTON ST
WATERTOWN, NY 13601
Jefferson County (315) 788-1751
MELISSA A CHARLEBOIS RPA C
Physician Assistant (Medical)
826 WASHINGTON ST, SUITE 204
WATERTOWN, NY 13601
Jefferson County (315) 788-1751
DR. ROBERT O KIMBALL M.D.
Surgery
826 WASHINGTON ST
WATERTOWN, NY 13601
Jefferson County (315) 782-1505
HEATHER IROBUNDA M.D.
Obstetrics & Gynecology
826 WASHINGTON ST
WATERTOWN, NY 13601
Jefferson County (315) 785-4624
MS. LAURA CHATHERINE COLIHAN RPA C
Physician Assistant
826 WASHINGTON ST, STE 106
WATERTOWN, NY 13601
Jefferson County (315) 786-2000
JEFFERSON EYE SURGEONS, LLP
Ophthalmology
826 WASHINGTON ST, SUITE 102
WATERTOWN, NY 13601
Jefferson County (315) 788-0022
BARBARA TERESA LICZNERSKI MD
Specialist
826 WASHINGTON ST, SUITE 104
WATERTOWN, NY 13601
Jefferson County (315) 786-1500

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 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.

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.