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JAIMIE VETTICHIRA SAMUEL D.O
NPI 1629479563
Pediatrics in Nanuet, NY

Active since September 10, 2014PECOS Enrolled
25 SMITH ST FL 2, NANUET, NY 10954(845) 623-7100 Get Directions Write a Review

NPPES record last updated: August 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 29, 2022, Oct 30, 2019, Jan 15, 2016 (3 updates tracked since 2016).

About Jaimie Vettichira Samuel D.o NPPES

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

JAIMIE VETTICHIRA SAMUEL D.O (NPI 1629479563) is an individual pediatrics provider in Nanuet, New York, licensed in New York (280311) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Vienna.

NPPES Registry Identity

NPI1629479563
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJAIMIE VETTICHIRA SAMUELCredential: D.O
Location Address25 SMITH ST FL 2Nanuet, NY 10954-2912
Mailing Address22 Poplar StElmsford, NY 10523-3726 · (914) 409-3103
Phone(845) 623-7100
Sole ProprietorNo
Enumeration DateSeptember 10, 2014
Last NPPES UpdateAugust 29, 20223 updates tracked since enumeration
NPPES CertifiedAugust 29, 2022
✔ NPI 1629479563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in NY · 280311✔ Licensed in VA · 0102205729
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
25 SMITH ST FL 2, Nanuet, NY 10954
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Secondary Practice Location 1

Location 1100 East St SE Ste 301Vienna, VA 22180-4800 · Phone (703) 938-5555

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaimie Vettichira Samuel D.o 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10954 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.

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 Jaimie Samuel's NPI number?

The NPI number for Jaimie Samuel is 1629479563. It was assigned to this individual provider in the NPPES registry on September 10, 2014.

Where is Jaimie Samuel located?

Jaimie Samuel practices at 25 Smith St Fl 2, Nanuet, NY 10954. The listed phone number is (845) 623-7100.

What is Jaimie Samuel's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jaimie Samuel enrolled in Medicare?

Yes. Jaimie Samuel is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jaimie Samuel was last updated on August 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.