DMITRY V SAMSONOV MD
NPI 1356595862
Pediatrics - Pediatric Nephrology in Hawthorne, NY
About Dmitry V Samsonov Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DMITRY V SAMSONOV MD (NPI 1356595862) is an individual pediatric nephrology provider in Hawthorne, New York, licensed in New York (269800) and active in the NPI registry since November 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1989).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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
Dmitry V Samsonov 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.
Medicare Billing Reassignments
3Medicare enrollment records show Dmitry Samsonov reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hawthorne, NY 10532
- Reassigned Medicare billing, New York enrollment
- 511 clinicians in this Medicare group
New York, NY 10037
- Reassigned Medicare billing, New York enrollment
- 2,094 clinicians in this Medicare group
New York, NY 10029
- Reassigned Medicare billing, New York enrollment
- 623 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.
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.
HAWTHORNE, NY 10532
HAWTHORNE, NY 10532
HAWTHORNE, NY 10532
HAWTHORNE, NY 10532
HAWTHORNE, NY 10532
HAWTHORNE, NY 10532
HAWTHORNE, NY 10532
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 Dmitry Samsonov's NPI number?
The NPI number for Dmitry Samsonov is 1356595862. It was assigned to this individual provider in the NPPES registry on November 11, 2008.
Where is Dmitry Samsonov located?
Dmitry Samsonov practices at 19 Bradhurst Ave Ste 1400, Hawthorne, NY 10532. The listed phone number is (914) 493-7583.
What is Dmitry Samsonov's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.
Is Dmitry Samsonov enrolled in Medicare?
Yes. Dmitry Samsonov 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 Dmitry Samsonov's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dmitry Samsonov reassigns Medicare benefits to 3 organizations: Boston Children's Health Physicians, LLP (Hawthorne, NY), Physician Affiliate Group Of New York PC (New York, NY) and Metropolitan Medical Practice Plan PC (New York, NY). 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 Dmitry Samsonov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Dmitry Samsonov was last updated on July 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Dmitry V Samsonov, MD · NPI 1356595862
Pediatric Nephrology physician in Hawthorne, New York. Individual provider, active in the CMS NPPES registry since November 11, 2008.
## Identity
- **NPI:** 1356595862 (Entity type: Individual)
- **Enumerated:** November 11, 2008
- **Primary specialty:** Pediatrics - Pediatric Nephrology · taxonomy 2080P0210X
- **State license:** 269800 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 19 BRADHURST AVE, STE 1400, Hawthorne, NY 10532-2140
- **Phone:** (914) 493-7583 · **Fax:** (914) 594-4011
## 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:** 3 organizations under Medicare reassignment (form CMS-855R): Boston Children's Health Physicians, LLP (NPI 1467454967, Hawthorne, NY); Physician Affiliate Group Of New York PC (NPI 1013375526, New York, NY); Metropolitan Medical Practice Plan PC (NPI 1306138383, New York, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1989
## Record status
- **NPPES last updated:** July 23, 2013
- **Other identifiers:** Medicare PIN A400045978 (NY); Medicaid 03266039 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1356595862) · Data from the CMS NPPES public registry.