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SAMUEL G PUTNAM MD NPI 1023066404


NPI Information

NPI: 1023066404
Provider Name: SAMUEL G PUTNAM, MD
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

Organization: MODERN VASCULAR OF DENVER, LLC

PECOS Registration: Yes

Address:
55 PHYSICIANS LN
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 655-2136
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Samuel G Putnam, MD is a vascular and interventional radiology radiology in Southaven, MS with 38 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. Samuel G Putnam, MD NPI is 1023066404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

55 PHYSICIANS LN
SOUTHAVEN, MS
ZIP 38671-569
Phone: (662) 655-2136
Fax: (662) 996-2214

The NPI 1023066404 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • Radiological supervision and interpretation of CT guidance for needle insertion (HCPCS:77012)

The enumeration date for this NPI number is 5/5/2006 and was last updated on 10/17/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyMD041221EPENNSYLVANIANo
22085R0202XRadiologyDiagnostic RadiologyC1-0011573DELAWARENo
32085R0204XRadiologyVascular & Interventional RadiologyMD041221EPENNSYLVANIANo
42085R0204XRadiologyVascular & Interventional RadiologyC1-0011573DELAWARENo
52085R0204XRadiologyVascular & Interventional Radiology63241TENNESSEENo
62085R0204XRadiologyVascular & Interventional Radiology28916MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10546464000OTHERPENNSYLVANIAIBC - PC/KHPE
230026885OTHERPENNSYLVANIAKEYSTONE MERCY
3300099781OTHERPENNSYLVANIARRM
40546464000OTHERPENNSYLVANIAAMERIHEALTH/INTERCOUNTY
5710371OTHERPENNSYLVANIAHIGHMARK BLUE SHIELD
67929044OTHERPENNSYLVANIAAETNA PPO
71172545OTHERPENNSYLVANIAAETNA HMO
80012723560016MEDICAIDPENNSYLVANIA
98215722OTHERPENNSYLVANIACIGNA HMO/PPO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.