MRS. MANJU BIJU SAM
NPI 1265067466
Nurse Practitioner - Adult Health in Stony Brook, NY

Q: What is Manju Sam's NPI number?

The NPI number for Manju Sam is 1265067466. It was assigned to this individual provider in the NPPES registry on March 8, 2020.

Q: What is Manju Sam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Manju Sam was last updated on November 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 08, 2020PECOS Enrolled

98.52/100

CMS Quality Rating

101 NICOLLS RD, STONY BROOK, NY 11794(631) 632-6868 Get Directions Write a Review

NPPES record last updated: November 23, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 23, 2021, Mar 8, 2020 (2 updates tracked since 2020).

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About Mrs. Manju Biju Sam NPPES

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

MRS. MANJU BIJU SAM (NPI 1265067466) is an individual adult health provider in Stony Brook, New York, licensed in New York (F309300-01) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265067466

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMRS. MANJU BIJU SAM

Location Address101 NICOLLS RDStony Brook, NY 11794-1923

Mailing Address4 Berwyn DrLake Ronkonkoma, NY 11779-1923 · (631) 525-1801

Phone(631) 632-6868

Sole ProprietorYes

Enumeration DateMarch 8, 2020

Last NPPES UpdateNovember 23, 20212 updates tracked since enumeration

NPPES CertifiedNovember 23, 2021

✔ NPI 1265067466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · F309300-01

101 NICOLLS RD, Stony Brook, NY 11794

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Manju Biju Sam is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Manju Sam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stony Brook Internists, University Faculty Practice Corporation

0.5 mi

Nephrology

SUNY @ STONY BROOK, HSC, L16, RM 020
Stony Brook, NY 11794

Reassigned Medicare billing, New York enrollment
261 clinicians in this Medicare group

NPI 1215976337 (631) 444-2448

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

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.

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.

98.52/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.85

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers14 claims14 services$67.50 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier13 claims13 services$35.89 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

NARINDER SINGH M.D.

Internal Medicine