1. Home
  2. Directory
  3. New York
  4. New York New York
  5. Pediatrics
  6. NPI Profile

SAMUEL MASTER D.O.
NPI 1720468408
Pediatrics - Adolescent Medicine in New York, NY

Active since June 08, 2015PECOS EnrolledAccepts Medicare Assignment
622 WEST 168TH ST, VC4, NEW YORK, NY 10032(212) 342-3233(212) 342-4733 Get Directions Write a Review

NPPES record last updated: December 5, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 5, 2024, Jul 9, 2018, Jul 7, 2018 (3 updates tracked since 2018).

About Samuel Master D.o. NPPES

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

SAMUEL MASTER D.O. (NPI 1720468408) is an individual adolescent medicine provider in New York, New York, licensed in New York (294447) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS and is a graduate of Rowan University School Of Osteopathic Medicine (2015).

NPPES Registry Identity

NPI1720468408
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameSAMUEL MASTERCredential: D.O.
Location Address622 WEST 168TH ST, VC4New York, NY 10032
Mailing Address622 West 168th St, Vc 4New York, NY 10032 · (212) 342-3200 · Fax (212) 342-4733
Phone(212) 342-3233
Fax(212) 342-4733
Sole ProprietorNo
Medical School CMSRowan University School Of Osteopathic MedicineGraduated 2015
Enumeration DateJune 8, 2015
Last NPPES UpdateDecember 5, 20243 updates tracked since enumeration
NPPES CertifiedDecember 5, 2024
✔ NPI 1720468408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in NY · 294447
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Also ListedPediatricsTaxonomy 208000000X · License OT016663 (PA), 294447 (NY)
622 WEST 168TH ST, New York, NY 10032
Open in Google Maps ↗

Other Identifiers 1

Medicaid22-2540851PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Master D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567708167
PECOS Enrollment IDI20210909000977
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 Reassignment

Medicare enrollment records show Samuel Master reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Trustees Of Columbia University In The City Of New York
Same address
Anesthesiology
622 W 168TH ST
New York, NY 10032
  • Reassigned Medicare billing, New York enrollment
  • 3,922 clinicians in this Medicare group
NPI 1477068971 (212) 305-9876

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

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARISSA NADEAU M.D.
Emergency Medicine
622 WEST 168TH ST, VC2-SUITE 260
NEW YORK, NY 10032
New York County (212) 305-2995
DAVID DE VINCK D.O.
Dermatology (Dermatopathology)
622 WEST 168TH ST, PH 1564W
NEW YORK, NY 10032
New York County (212) 305-7399
DR. ROBERT CHARLES BASNER MD
Internal Medicine (Pulmonary Disease)
622 WEST 168TH ST, PH859
NEW YORK, NY 10032
New York County (212) 305-7591
RICHARD FRANCIS M.D.
Pathology (Anatomic Pathology)
622 WEST 168TH ST, PH 1564W
NEW YORK, NY 10032
New York County (212) 305-7399
TIFFANY LUKE
Student in an Organized Health Care Education/Training Program
622 WEST 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6100
MR. SIVAGNANAM KESAVAN RPH
Pharmacist
622 WEST 168TH ST, NEW YORK-PRESBYTARIAN HOSPITAL
NEW YORK, NY 10032
New York County (212) 342-8645
KYUNGJUN THOMAS LEE
Student in an Organized Health Care Education/Training Program
622 WEST 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6100
HENRY LIN MD
Emergency Medicine
622 WEST 168TH ST, PH-1-137
NEW YORK, NY 10032
New York County (212) 305-2995

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 Samuel Master's NPI number?

The NPI number for Samuel Master is 1720468408. It was assigned to this individual provider in the NPPES registry on June 8, 2015.

Where is Samuel Master located?

Samuel Master practices at 622 West 168th St Vc4, New York, NY 10032. The listed phone number is (212) 342-3233.

What is Samuel Master's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Samuel Master enrolled in Medicare?

Yes. Samuel Master is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Samuel Master's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Master reassigns Medicare benefits to Trustees Of Columbia University In The City Of New York (New York, NY). The 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 Samuel Master'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 Samuel Master was last updated on December 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.