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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: November 01, 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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Jaimie Samuel reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Medical Services Of Manhasset, PC
Same address
Pediatrics
25 SMITH ST STE 210
Nanuet, NY 10954
  • Reassigned Medicare billing, New York enrollment
  • 8 clinicians in this Medicare group
NPI 1659141679 (845) 623-7100
Phelps Faculty Medical Affiliates University Faculty Practice Corpor
Same address
Pediatrics
25 SMITH ST STE 210
Nanuet, NY 10954
  • Reassigned Medicare billing, New York enrollment
  • 13 clinicians in this Medicare group
NPI 1912853722 (845) 623-7100
Boston Children's Health Physicians, LLP
9.5 mi
Pediatrics
19 SKYLINE DR OFC 1N-D06
Hawthorne, NY 10532
  • Reassigned Medicare billing, New York enrollment
  • 511 clinicians in this Medicare group
NPI 1467454967 (914) 594-2100
Mount Vernon Neighborhood Health Center Inc
15 mi
Specialist
107 W 4TH ST, ADMINISTRATION
Mount Vernon, NY 10550
  • Reassigned Medicare billing, New York enrollment
  • 108 clinicians in this Medicare group
NPI 1295912541 (914) 699-7200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organizations bill Medicare for Jaimie Samuel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaimie Samuel reassigns Medicare benefits to 4 organizations: Medical Services Of Manhasset, PC (Nanuet, NY), Phelps Faculty Medical Affiliates University Faculty Practice Corpor (Nanuet, NY), Boston Children's Health Physicians, LLP (Hawthorne, NY) and Mount Vernon Neighborhood Health Center Inc (Mount Vernon, 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 Jaimie Samuel'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 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 4 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.