Individual provider

Samuel Pennella, MD

General Practice Physician Medicare enrolled

Samuel Pennella, MD is a General Practice Physician in Detroit, MI, registered under NPI 1124524038. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 607 SHELBY ST STE 700, Detroit, MI 48226. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

607 SHELBY ST STE 700, Detroit, MI 48226 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
4301510893 MI General Practice Physician primary
68449 MN General Practice Physician
TW00059 KS General Practice Physician
TPME2986 FL General Practice Physician
DR.0074417 CO General Practice Physician

Licences are recorded in 5 states: MI, MN, KS, FL, CO. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - General Practice
PAC ID
8123427267

Medicare enrolment is recorded as approved under the provider type Practitioner - General Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 5 states

This provider holds licences in 5 states: Colorado, Florida, Kansas, Michigan and Minnesota. The practice address on file is in Detroit, MI, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

CO Colorado
Licence
DR.0074417
Specialty
General Practice Physician
Verify with the CO board →
FL Florida
Licence
TPME2986
Specialty
General Practice Physician
Verify with the FL board →
KS Kansas
Licence
TW00059
Specialty
General Practice Physician
Verify with the KS board →
MI Michigan practice address
Licence
4301510893
Specialty
General Practice Physician
Verify with the MI board →
MN Minnesota
Licence
68449
Specialty
General Practice Physician
Verify with the MN board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What General Practice covers

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. NUCC Health Care Provider Taxonomy, code 208D00000X
Allopathic & Osteopathic Physicians General Practice

All registered taxonomy codes

This provider registers 5 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
208D00000X General Practice Physician 4301510893 MI primary
208D00000X General Practice Physician 68449 MN
208D00000X General Practice Physician TW00059 KS
208D00000X General Practice Physician TPME2986 FL
208D00000X General Practice Physician DR.0074417 CO

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1124524038 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 2, 2018
Last updatedMay 6, 2026
StatusActive
Sole proprietorYes
CredentialMD
Practice address 607 SHELBY ST STE 700
Detroit, MI 48226
(908) 208-8926
Mailing address 14 GLENNON FARM LN
Lebanon, NJ 08833
This record was updated on May 6, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1124524038 passes the NPI check digit test The final digit 8 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 2 4 5 2 4 0 3
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 4 4 1 2 8 0 6

Sum = 52 · next multiple of 10 = 60 · check digit = 8 · actual last digit = 8

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1124524038?
NPI 1124524038 is the National Provider Identifier assigned to Samuel Pennella, MD in Detroit, MI. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does General Practice Physician cover?
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
How do I contact Samuel Pennella, MD?
The phone number on file with NPPES is (908) 208-8926, last updated May 6, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Samuel Pennella, MD accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1124524038 a valid number?
Yes. 1124524038 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.