MRS. JESSY SAMUEL FNP
NPI 1154940450
Nurse Practitioner - Family in Paterson, NJ
About Mrs. Jessy Samuel Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JESSY SAMUEL FNP (NPI 1154940450) is an individual family provider in Paterson, New Jersey, licensed in New Jersey (26NJ01027200) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Mrs. Jessy Samuel Fnp 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.
Medicare Billing Reassignments
2Medicare enrollment records show Jessy Samuel reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bloomfield, NJ 07003
- Reassigned Medicare billing, New Jersey enrollment
- 6 clinicians in this Medicare group
Belleville, NJ 07109
- Reassigned Medicare billing, New Jersey enrollment
- 14 clinicians in this Medicare group
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 2
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 07503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PATERSON, NJ 07503
PATERSON, NJ 07503
PATERSON, NJ 07503
PATERSON, NJ 07503
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 Jessy Samuel's NPI number?
The NPI number for Jessy Samuel is 1154940450. It was assigned to this individual provider in the NPPES registry on April 16, 2020.
Where is Jessy Samuel located?
Jessy Samuel practices at 703 Main St, Paterson, NJ 07503. The listed phone number is (973) 754-2000.
What is Jessy Samuel's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jessy Samuel enrolled in Medicare?
Yes. Jessy 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 organizations bill Medicare for Jessy Samuel's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jessy Samuel reassigns Medicare benefits to 2 organizations: John V. Kelly MD, PC (Bloomfield, NJ) and Oak Tree Healthcare PA (Belleville, NJ). Each 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 Jessy Samuel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jessy Samuel accept?
Health plans from Oscar Health list Jessy Samuel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jessy Samuel was last updated on April 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Mrs. Jessy Samuel, FNP · NPI 1154940450
Family physician in Paterson, New Jersey. Individual provider, active in the CMS NPPES registry since April 16, 2020.
## Identity
- **NPI:** 1154940450 (Entity type: Individual)
- **Enumerated:** April 16, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 26NJ01027200 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 703 MAIN ST, Paterson, NJ 07503-2621
- **Phone:** (973) 754-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): John V. Kelly MD, PC (NPI 1417065830, Bloomfield, NJ); Oak Tree Healthcare PA (NPI 1083368674, Belleville, NJ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** April 16, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1154940450) · Data from the CMS NPPES public registry.