Gennie Samala, is a medicare enrolled "Social Worker - Clinical" provider in Los Angeles, California. Her current practice location is
515 Columbia Ave Ste 100, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(213) 553-1884.
Gennie Samala is licensed to practice in California (license number 112414) 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 1407304777.
Healthcare Provider's Profile
Full Name | Gennie Samala |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 515 Columbia Ave Ste 100, Los Angeles, California |
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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: 1407304777
- Provider Enumeration Date: 09/15/2016
- Last Update Date: 12/08/2022
Medicare PECOS Information:
- PECOS PAC ID: 5597139220
- Enrollment ID: I20230321001443
Medical Identifiers
Medical identifiers for Gennie Samala such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407304777 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 79344 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 112414 (California) | 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. Gennie Samala allows following entities to bill medicare on her behalf.
Entity Name | Special Service For Groups |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1952442949 PECOS PAC ID: 2769396886 Enrollment ID: O20031113000561 |
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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. Gennie Samala 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 |
Gennie Samala, 1730 W Olympic Blvd, Los Angeles, CA 90015-1019 Ph: (213) 553-1884 | Gennie Samala, 515 Columbia Ave Ste 100, Los Angeles, CA 90017-1209 Ph: (213) 553-1884 |
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