Dr Samantha Jimenez, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Bellevue, Washington. Her current practice location is
13451 Se 36th St, Bellevue, Washington. You can reach out to her office (for appointments etc.) via phone at
(425) 562-1337.
Dr Samantha Jimenez is licensed to practice in Washington (license number PY60480722) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1619302072.
Healthcare Provider's Profile
Full Name | Dr Samantha Jimenez |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 13451 Se 36th St, Bellevue, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1619302072
- Provider Enumeration Date: 09/04/2013
- Last Update Date: 05/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 8022441633
- Enrollment ID: I20191211002372
Medical Identifiers
Medical identifiers for Dr Samantha Jimenez such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619302072 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | MC60269765 (Washington) | Secondary |
103TC0700X | Psychologist - Clinical | PY60480722 (Washington) | Primary |
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. Dr Samantha Jimenez allows following entities to bill medicare on her behalf.
Entity Name | Kaiser Foundation Health Plan Of Washington |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1396810701 PECOS PAC ID: 9032022579 Enrollment ID: O20031112000454 |
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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. Dr Samantha Jimenez 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 |
Dr Samantha Jimenez, PSYD 13451 Se 36th St, Bellevue, WA 98006-1475 Ph: (425) 562-1337 | Dr Samantha Jimenez, PSYD 13451 Se 36th St, Bellevue, WA 98006-1475 Ph: (425) 562-1337 |
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