MARK SAMUELSEN PA-C
NPI 1407381213
Physician Assistant - Surgical in Boston, MA
About Mark Samuelsen Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARK SAMUELSEN PA-C (NPI 1407381213) is an individual surgical provider in Boston, Massachusetts and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mark Samuelsen Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
BOSTON, MA 02114
BOSTON, MA 02114
BOSTON, MA 02114
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 Mark Samuelsen's NPI number?
The NPI number for Mark Samuelsen is 1407381213. It was assigned to this individual provider in the NPPES registry on April 30, 2017.
Where is Mark Samuelsen located?
Mark Samuelsen practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 726-2000.
What is Mark Samuelsen's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Mark Samuelsen enrolled in Medicare?
Yes. Mark Samuelsen is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Mark Samuelsen was last updated on April 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Mark Samuelsen, PA-C · NPI 1407381213
Surgical physician in Boston, Massachusetts. Individual provider, active in the CMS NPPES registry since April 30, 2017.
## Identity
- **NPI:** 1407381213 (Entity type: Individual)
- **Enumerated:** April 30, 2017
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **Sole proprietor:** No
## Practice location
- **Address:** 55 FRUIT ST, Boston, MA 02114-2621
- **Phone:** (617) 726-2000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 30, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1407381213) · Data from the CMS NPPES public registry.