SUSAN ALSAMARAI (NPI# 1174734768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174734768 |
| Entity Type | Individual |
| Full Name | SUSAN ALSAMARAI |
| Credential | MD |
| Practice Address |
455 Lewis Ave Midstate Medical Group, PC Meriden CT 06451-2121 |
| Practice Telephone | 2032387747 |
| Practice Fax Number | 2036860282 |
| Mailing Telephone | 2032387747 |
| Mailing Fax Number | 2032387747 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 050729 | CT | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 248940 | NY | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
050729 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | PENDING | 05 |
| Street Address |
455 LEWIS AVE MIDSTATE MEDICAL GROUP, PC |
| City | MERIDEN |
| State | CT |
| Zip Code | 06451-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710986898 | David M Sack | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2005-07-20 |
| 1740601665 | Katelyn Spence | Nurse Practitioner | 455 Lewis Ave, Suite 220, Meriden, CT 06451-2121 | 2013-12-18 |
| 1336491752 | Hartford Healthcare Medical Group, Inc | Urology | 455 Lewis Ave, Ste. 210, Meriden, CT 06451-2121 | 2012-10-09 |
| 1316227291 | Hartford Clinical Associates, PC | Urology | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2011-08-23 |
| 1265669089 | Madhavi Bhoomagoud | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2009-06-18 |
| 1982839247 | Connecticut Nephrology Associates LLC | Internal Medicine | 455 Lewis Ave, Suite 214, Meriden, CT 06451-2121 | 2009-05-15 |
| 1639316177 | Rafal Barczak | Surgery | 455 Lewis Ave, Meriden, CT 06451-2121 | 2009-01-20 |
| 1598919045 | Paul Pyo | Urology | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2008-11-11 |
| 1962654178 | Bluegrass Medicine & Nephrology, LLC | Clinic/Center | 455 Lewis Ave, Suite 214, Meriden, CT 06451-2121 | 2008-10-21 |
| 1366692691 | Aly Hemdan Abdalla | Internal Medicine | 455 Lewis Ave, Suite 206, Meriden, CT 06451-2121 | 2008-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1235599333 | Mcm Dental, LLC | Dentist | 74 Main Street, Lakewood, CT 06451 | 2016-03-02 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
| Find all providers in zip 06451 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770524753 | Gerard Fumo | Internal Medicine | 455 Lewis Ave, Suite 102, Meriden, CT 06451-2121 | 2006-06-09 |
| 1356380232 | Gary F Tansino | Internal Medicine | 455 Lewis Ave, Suite 102, Meriden, CT 06451-2121 | 2006-06-06 |
| 1740229632 | Kathleen Bober-sorcinelli | Internal Medicine | 435 Lewis Avenue, Suite 220, Meriden, CT 06451 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154751907 | David S Fischer | Internal Medicine | 17 Abigail St, Milford, CT 06460-7918 | 2013-11-14 |
| 1265746879 | Eric Bleickardt | Internal Medicine | 3 Hidden Brook Rd, Hamden, CT 06518-1764 | 2010-08-06 |
| 1467763946 | Kelsey Thompson Martin | Internal Medicine | 240 Indian River Rd Ste A1, Orange, CT 06477-3690 | 2010-06-29 |
| 1780907295 | Kenneth L Sacks | Internal Medicine | 10 Oyster Landing Rd, Milford, CT 06460-6566 | 2010-03-11 |
| 1396981668 | Michael W Rosen | Internal Medicine | 32 Mackay Farm Rd, Woodbury, CT 06798-2509 | 2008-12-17 |
| 1083879134 | Jia Li | Internal Medicine | 950 Campbell Ave # 111d, West Haven, CT 06516-2770 | 2008-07-28 |
| 1760643407 | Sudhanshu Bharat Mulay | Internal Medicine | 114 Woodland Street / Cancer Center, Saint Francis Medical Group, Inc, Hartford, CT 06105-0000 | 2008-06-24 |
| 1194938324 | Anamika Katoch | Internal Medicine | 1075 Chase Pkwy Ste B, Harold Leever Cancer Center, Waterbury, CT 06708-2948 | 2007-05-07 |
| 1760694327 | Joseph Donadio | Internal Medicine | 140 Blue Hills Rd, Durham, CT 06422-3100 | 2007-05-04 |
| 1720136757 | Wylie David Hosmer | Internal Medicine | 55 Meriden Ave Ste 1a, Southington, CT 06489-3237 | 2007-01-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.