MR. SAMUEL DAVID SOUTH MD
NPI 1154664282
Surgery in Saint Paul, MN
About Mr. Samuel David South Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. SAMUEL DAVID SOUTH MD (NPI 1154664282) is an individual surgery provider in Saint Paul, Minnesota, licensed in Minnesota (83232) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of University Of Utah School Of Medicine (2013).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 3
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
Mr. Samuel David South Md 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.
Areas of Expertise CMS Part B claims 8
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
SAINT PAUL, MN 55101
ST PAUL, MN 55101
ST PAUL, MN 55101
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 Samuel South's NPI number?
The NPI number for Samuel South is 1154664282. It was assigned to this individual provider in the NPPES registry on March 27, 2013.
Where is Samuel South located?
Samuel South practices at 640 Jackson St, Saint Paul, MN 55101. The listed phone number is (952) 967-7977.
What is Samuel South's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Samuel South enrolled in Medicare?
Yes. Samuel South 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.
When was this NPI record last updated?
The NPPES record for Samuel South was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.
# Mr. Samuel David South, MD · NPI 1154664282
Surgery physician in Saint Paul, Minnesota. Individual provider, active in the CMS NPPES registry since March 27, 2013.
## Identity
- **NPI:** 1154664282 (Entity type: Individual)
- **Enumerated:** March 27, 2013
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 83232 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 640 JACKSON ST, Saint Paul, MN 55101-2502
- **Phone:** (952) 967-7977 · **Fax:** (651) 254-7990
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Utah School Of Medicine, class of 2013
## Record status
- **NPPES last updated:** September 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1154664282) · Data from the CMS NPPES public registry.