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DR. SAMUEL DAVID MALDONADO JR. MD, PHD
NPI 1972130912
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since March 26, 2020PECOS EnrolledAccepts Medicare Assignment
55 FRUIT STREET, BUL-1-130, BOSTON, MA 02114(617) 726-3906(617) 643-4237 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Dec 2, 2025, Feb 20, 2023, Mar 26, 2020 (3 updates tracked since 2020).

About Dr. Samuel David Maldonado Jr. Md, Phd NPPES

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

DR. SAMUEL DAVID MALDONADO JR. MD, PHD (NPI 1972130912) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Massachusetts General Hospital, and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1972130912
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. SAMUEL DAVID MALDONADO JR.Credential: MD, PHD
Location Address55 FRUIT STREET, BUL-1-130Boston, MA 02114
Mailing Address1215 Lee St Box 800744Charlottesville, VA 22908-0816 · (434) 924-1931 · Fax (434) 243-5770
Phone(617) 726-3906
Fax(617) 643-4237
Sole ProprietorNo
Medical School CMSRutgers New Jersey Medical SchoolGraduated 2020
Enumeration DateMarch 26, 2020
Last NPPES UpdateDecember 2, 20253 updates tracked since enumeration
NPPES CertifiedDecember 2, 2025
✔ NPI 1972130912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
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.
Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X · License 1021380 (MA)
55 FRUIT STREET, BUL-1-130, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Location 1

Location 175 Francis StBoston, MA 02115-6110 · Phone (617) 732-5500

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Samuel David Maldonado Jr. Md, Phd 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 ID5193194322
PECOS Enrollment IDI20250708000931
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Massachusetts General Hospital

Acute Care Hospitals · Boston, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220071
Location55 Fruit StreetBoston, MA 02114 · Suffolk County
Emergency services Birthing friendly

Newton-Wellesley Hospital

Acute Care Hospitals · Newton, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220101
Location2014 Washington StreetNewton, MA 02462 · Middlesex County
Emergency services Birthing friendly

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 Maldonado's NPI number?

The NPI number for Samuel Maldonado is 1972130912. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Samuel Maldonado located?

Samuel Maldonado practices at 55 Fruit Street, Bul-1-130, Boston, MA 02114. The listed phone number is (617) 726-3906.

What is Samuel Maldonado'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 Maldonado enrolled in Medicare?

Yes. Samuel Maldonado 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.

What insurance does Samuel Maldonado accept?

Health plans from Anthem Blue Cross and Blue Shield list Samuel Maldonado as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samuel Maldonado affiliated with any hospitals?

According to CMS data, Samuel Maldonado is affiliated with Massachusetts General Hospital and Newton-Wellesley Hospital.

When was this NPI record last updated?

The NPPES record for Samuel Maldonado was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.