Samuel Eli Peckham, APRN is a medicare enrolled "Nurse Practitioner - Family" provider in Norwich, Connecticut. He graduated from medical school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Northeast Medical Group Inc and his current practice location is
47 Town St, Norwich, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 892-7042.
Samuel Eli Peckham is licensed to practice in Connecticut (license number 6659) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1447301163.
Healthcare Provider's Profile
| Full Name | Samuel Eli Peckham |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 8 Years |
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| Location | 47 Town St, Norwich, Connecticut |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Samuel Eli Peckham graduated from medical school in 2016
NPI Data:
- NPI Number: 1447301163
- Provider Enumeration Date: 01/16/2007
- Last Update Date: 09/16/2016
Medicare PECOS Information:
- PECOS PAC ID: 3173802527
- Enrollment ID: I20161108001280
Medical Identifiers
Medical identifiers for Samuel Eli Peckham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1447301163 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 171100000X | Acupuncturist | 239 (Connecticut) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 6659 (Connecticut) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Northeast Medical Group Inc | 1254233836 | 1244 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel Eli Peckham allows following entities to bill medicare on his behalf.
| Provider Name | Northeast Medical Group Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1043278351
PECOS PAC ID: 1254233836
Enrollment ID: O20040123000522 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Eli Peckham is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Samuel Eli Peckham, APRN
47 Town St,
Norwich, CT 06360-2323
Ph: (860) 892-7042 | Samuel Eli Peckham, APRN
47 Town St,
Norwich, CT 06360-2323
Ph: (860) 892-7042 |
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