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SAMANTHA DMYTROW
NPI 1568064228
Counselor - Addiction (Substance Use Disorder) in Staten Island, NY

Active since November 09, 2020PECOS Enrolled
3911 RICHMOND AVE, STATEN ISLAND, NY 10312(718) 948-3232 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 9, 2025, Nov 9, 2020 (2 updates tracked since 2020).

About Samantha Dmytrow NPPES

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

SAMANTHA DMYTROW (NPI 1568064228) is an individual addiction (substance use disorder) provider in Staten Island, New York and active in the NPI registry since November 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568064228
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameSAMANTHA DMYTROW
Location Address3911 RICHMOND AVEStaten Island, NY 10312-5110
Mailing Address3911 Richmond AveStaten Island, NY 10312-5110
Phone(718) 948-3232
Sole ProprietorNo
Enumeration DateNovember 9, 2020
Last NPPES UpdateJune 9, 20252 updates tracked since enumeration
NPPES CertifiedJune 9, 2025
✔ NPI 1568064228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
3911 RICHMOND AVE, Staten Island, NY 10312
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Other Identifiers 1

Medicaid131624228NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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)

Samantha Dmytrow 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.

YMCA OF GREATER NEW YORK
Clinic/Center (Rehabilitation, Substance Use Disorder)
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
WILLIAM COBB CASAC-T
Counselor (Addiction (Substance Use Disorder))
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
AMANDA WEXLER LCSW
Social Worker (Clinical)
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
DARIEN HIMI
Counselor
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
BARBARA ANN KELLY CASACT
Counselor (Addiction (Substance Use Disorder))
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
OLGA AFANASEVA
Social Worker
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
MELISSA ANN TORRES C.A.S.A.C
Counselor (Addiction (Substance Use Disorder))
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3232
SAMANTHA ANN WERLICK
Counselor (Mental Health)
3911 RICHMOND AVE
STATEN ISLAND, NY 10312
Richmond County (718) 689-4502

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 Samantha Dmytrow's NPI number?

The NPI number for Samantha Dmytrow is 1568064228. It was assigned to this individual provider in the NPPES registry on November 9, 2020.

Where is Samantha Dmytrow located?

Samantha Dmytrow practices at 3911 Richmond Ave, Staten Island, NY 10312. The listed phone number is (718) 948-3232.

What is Samantha Dmytrow's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Samantha Dmytrow enrolled in Medicare?

Yes. Samantha Dmytrow is registered in the Medicare PECOS enrollment system.

What insurance does Samantha Dmytrow accept?

Health plans from Providence Health Plan list Samantha Dmytrow 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 Samantha Dmytrow was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.