SAMUEL GAGNE
NPI 1508397753
Student in an Organized Health Care Education/Training Program in Bronx, NY

Q: What is Samuel Gagne's NPI number?

The NPI number for Samuel Gagne is 1508397753. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Q: What is Samuel Gagne's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Gagne was last updated on March 21, 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.

Active since March 21, 2017PECOS Enrolled

111 E 210TH ST, BRONX, NY 10467(718) 741-2460(718) 654-6692 Get Directions Write a Review

NPPES record last updated: March 21, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Samuel Gagne NPPES

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

SAMUEL GAGNE (NPI 1508397753) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508397753

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL GAGNE

Location Address111 E 210TH STBronx, NY 10467-2401

Mailing Address111 E 210th StBronx, NY 10467-2401 · (718) 741-2460 · Fax (718) 654-6692

Phone(718) 741-2460

Fax(718) 654-6692

Sole ProprietorNo

Enumeration DateMarch 21, 2017

✔ NPI 1508397753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

111 E 210TH ST, Bronx, NY 10467

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Gagne 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.

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.

DR. MADHU SHARMA MD

Pediatrics (Pediatric Cardiology)

111 E 210TH ST, MONTEFIORE MEDICAL CENTER
BRONX, NY 10467

Bronx County (718) 741-2538

DR. AMANDA MCNEAR JACOBS M.D.

Pediatrics (Adolescent Medicine)

111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467

Bronx County (718) 920-2306

HEATHER ROOT MD

Internal Medicine (Infectious Disease)