DR. SHOJI OLIVO SAMSON DO
NPI 1831504067
Pediatrics - Neonatal-Perinatal Medicine in Chicago, IL

Q: What is Shoji Samson's NPI number?

The NPI number for Shoji Samson is 1831504067. It was assigned to this individual provider in the NPPES registry on June 26, 2014.

Q: What is Shoji Samson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for Shoji Samson was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 26, 2014PECOS Enrolled

5841 S MARYLAND AVE, CHICAGO, IL 60637(888) 824-0200 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 25, 2026, Jan 4, 2022, Apr 6, 2020 and 4 more (7 updates tracked since 2017).

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About Dr. Shoji Olivo Samson Do NPPES

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

DR. SHOJI OLIVO SAMSON DO (NPI 1831504067) is an individual neonatal-perinatal medicine provider in Chicago, Illinois, licensed in Illinois (036152483) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1831504067

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameDR. SHOJI OLIVO SAMSONCredential: DO

Location Address5841 S MARYLAND AVEChicago, IL 60637-1443

Mailing Address530 Ns Glen Oak AvenuePeoria, IL 61637-0001 · (096) 242-8963

Phone(888) 824-0200

Sole ProprietorYes

Enumeration DateJune 26, 2014

Last NPPES UpdateMarch 25, 20267 updates tracked since enumeration

NPPES CertifiedMarch 25, 2026

✔ NPI 1831504067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

Licenses✔ Licensed in IL · 036152483✔ Licensed in IA · DO-05910✔ Licensed in TX · S0375✔ Licensed in NY · 288816

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

Also ListedPediatricsTaxonomy 208000000X · License DO-05910 (IA), 288816 (NY), 036152483 (IL), S0375 (TX)

5841 S MARYLAND AVE, Chicago, IL 60637

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Secondary Practice Locations 3

Location 1507 E Armstrong AvePeoria, IL 61603-3201 · Phone (309) 681-9690 · Fax (309) 681-6965

Location 2530 Ns Glen Oak AvenuePeoria, IL 61637-0001 · Phone (309) 624-2896 · Fax (309) 655-2974

Location 32200 E Washington StBloomington, IL 61701-4364 · Phone (309) 662-3311

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. Shoji Olivo Samson Do 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. DON MARTINEZ M.D.

Radiology (Diagnostic Radiology)