MOHAMED ELSAYED ELSAMRA – Family Nurse Practitioner, NPI 1023819679

MOHAMED ELSAYED ELSAMRA is a healthcare provider. based in Fair lawn, New Jersey. specializing in NURSE PRACTITIONER. They hold a License No. 26NJ15292800 (NJ). The NPI Number for MOHAMED ELSAYED ELSAMRA is 1023819679

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
MOHAMED ELSAYED ELSAMRA
NPI
1023819679
Phone
(862) 247-3694
Address
13-20 3RD ST
Enumeration Date
20 March 2025
Last Update Date
22 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6315347246
Graduation Year
2024 (2 years ago)
PAC ID
3476072398
Group Practice PAC ID
7618219361
Professional Enrollment ID
I20250523000922
Address ID
NJ070323387KE206XXAVEX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

7,515 NURSE PRACTITIONER in NJ

Provider Addresses for MOHAMED ELSAYED ELSAMRA

  • 13-20 3RD ST

    FAIR LAWN, NJ 074101151

    Phone: (862) 247-3694

    Type: Mailing

  • 206 BERGEN AVE STE 207

    KEARNY, NJ 070323387

    Phone: (631) 534-7246

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250523000922INurse PractitionerNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 07410)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618219361View full group profile
NameSpecialtyState
Diagnostic RadiologyNY
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Diagnostic Radiology, Interventional RadiologyPA
Diagnostic RadiologyNJ

Reviews

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Frequently asked questions

What unique ID ties claims to MOHAMED ELSAYED ELSAMRA?
NPI 1023819679 is assigned to MOHAMED ELSAYED ELSAMRA under the national enumeration system.
Is MOHAMED ELSAYED ELSAMRA's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MOHAMED ELSAYED ELSAMRA list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for MOHAMED ELSAYED ELSAMRA. Clinical services aligned with this taxonomy classification.
What location metadata exists for MOHAMED ELSAYED ELSAMRA?
The page summarizes Fair Lawn, New Jersey for MOHAMED ELSAYED ELSAMRA; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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