Samantha Ellis, MS, RD is a medicare enrolled "Dietitian, Registered" provider in Walden, New York. She went to City University Of New York School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as Registered Dietitian Or Nutrition Professional. She is a member of the group practice Lgc Nutrition Llc and her current practice location is
44 Pleasant Ave, Walden, New York. You can reach out to her office (for appointments etc.) via phone at
(845) 597-8128.
Samantha Ellis is licensed to practice in New York (license number 1033283) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1285044750.
Healthcare Provider's Profile
| Full Name | Samantha Ellis |
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| Gender | Female |
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| Speciality | Registered Dietitian Or Nutrition Professional |
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| Experience | 13 Years |
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| Location | 44 Pleasant Ave, Walden, New York |
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| Accepts Medicare Assignments | Yes. She 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:
- Samantha Ellis attended and graduated from City University Of New York School Of Medicine in 2011
NPI Data:
- NPI Number: 1285044750
- Provider Enumeration Date: 05/05/2014
- Last Update Date: 05/05/2014
Medicare PECOS Information:
- PECOS PAC ID: 2365841657
- Enrollment ID: I20210518001940
Medical Identifiers
Medical identifiers for Samantha Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1285044750 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 1033283 (New York) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Lgc Nutrition Llc | 5496167488 | 3 |
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. Samantha Ellis allows following entities to bill medicare on her behalf.
| Provider Name | Marc D Price Do Pllc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1902816473
PECOS PAC ID: 8527089267
Enrollment ID: O20051209000478 |
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| Provider Name | Lgc Nutrition Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1750983995
PECOS PAC ID: 5496167488
Enrollment ID: O20201216000648 |
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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. Samantha Ellis 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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Samantha Ellis, MS, RD
44 Pleasant Ave,
Walden, NY 12586-1240
Ph: (845) 597-8128 | Samantha Ellis, MS, RD
44 Pleasant Ave,
Walden, NY 12586-1240
Ph: (845) 597-8128 |
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