Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shelby Kevin Samuel, MD

Individual provider Gastroenterology Physician · NPI 1114947157

Dr. Shelby Kevin Samuel, MD practises Gastroenterology in Brooklyn, New York. Graduated from State University of New York Downstate Medical Center in 1986, 40 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
40
Trained at
State University of New York Downstate Medical Center
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 Brooklyn Ave
Brooklyn, NY 11213-1908 Not confirmed with CMS for 14 years — call before visiting
Phone: (718) 498-7888
Fax: (718) 604-7890
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 176352 (NY)

Record details

NPI number1114947157
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 20, 2006
Last updated in NPPESFebruary 10, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduated 1986 (40 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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