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DR. SAMUEL THEODORE ELEY MD
NPI 1790487437
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since March 20, 2023PECOS Enrolled
15 PARKMAN STREET, WACC 625, BOSTON, MA 02114(617) 724-8135(617) 724-8010 Get Directions Write a Review

NPPES record last updated: May 26, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 26, 2023, Mar 20, 2023 (2 updates tracked since 2023).

About Dr. Samuel Theodore Eley Md NPPES

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

DR. SAMUEL THEODORE ELEY MD (NPI 1790487437) is an individual student in an organized health care education/training program in Boston, Massachusetts, licensed in Massachusetts (PENDING) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790487437
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. SAMUEL THEODORE ELEYCredential: MD
Location Address15 PARKMAN STREET, WACC 625Boston, MA 02114-2621
Mailing Address15 Parkman Street, Wacc 625Boston, MA 02114-2621 · (617) 724-8135 · Fax (617) 724-8010
Phone(617) 724-8135
Fax(617) 724-8010
Sole ProprietorNo
Enumeration DateMarch 20, 2023
Last NPPES UpdateMay 26, 20232 updates tracked since enumeration
NPPES CertifiedMay 26, 2023
✔ NPI 1790487437 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
License✔ Licensed in MA · PENDING
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.
15 PARKMAN STREET, Boston, MA 02114
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Theodore Eley Md 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. RONALD JON KULICH PHD
Psychologist
15 PARKMAN STREET, WAC 3 ANESTHESIA PAIN MANAGEMENT
BOSTON, MA 02114
Suffolk County (617) 726-3332
MATTHEW J BELLANICH NP
Nurse Practitioner
15 PARKMAN STREET, WAC 8 MGH NEUROLOGY ASSOCIATES
BOSTON, MA 02114
Suffolk County (617) 724-3914
DR. LAURA J HU MD
Internal Medicine
15 PARKMAN STREET, WAC605 INTERNAL MEDICINE ASSOCIATES TEAM 2
BOSTON, MA 02114
Suffolk County (617) 724-8400
DR. JASON ANDREW FAWLEY M.D.
Surgery
15 PARKMAN STREET, CHURCHILL SURGICAL CLINIC
BOST, MA 02114
Suffolk County (617) 643-7557
JENNIFER BURBRIDGE PHD
Psychologist
15 PARKMAN STREET, WAC 8 MGH PSYCHIATRY SERVICES
BOSTON, MA 02114
Suffolk County (617) 724-6300
DR. DANIEL EDWIN SINGER MD
Internal Medicine
15 PARKMAN STREET, WAC 635 INTERNAL MEDICINE ASSOCIATES TEAM 3
BOSTON, MA 02114
Suffolk County (617) 726-8157
MICHELLE L'HEUREUX M.D.
Internal Medicine
15 PARKMAN STREET, WANG AMBULATORY CARE CENTER FLOOR 6
BOSTON, MA 02114
Suffolk County (800) 711-4644
DR. NANCY J KEUTHEN PHD
Psychologist
15 PARKMAN STREET, WANG AMBULATORY CARE CENTER 815
BOSTON, MA 02114
Suffolk County (617) 726-4074

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 Eley's NPI number?

The NPI number for Samuel Eley is 1790487437. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Where is Samuel Eley located?

Samuel Eley practices at 15 Parkman Street Wacc 625, Boston, MA 02114. The listed phone number is (617) 724-8135.

What is Samuel Eley's specialty?

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

Is Samuel Eley enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samuel Eley was last updated on May 26, 2023. 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.