Dr Samantha Alecia Mix-souther, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Kalamazoo, Michigan. She graduated from medical school in 2016 and has 8 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Permanente Medical Group Inc and her current practice location is
1000 Oakland Dr, Kalamazoo, Michigan. You can reach out to her office (for appointments etc.) via phone at
(269) 337-4400.
Dr Samantha Alecia Mix-souther is licensed to practice in Michigan (license number 4301110346) 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 1063816684.
Physician's Profile
| Full Name | Dr Samantha Alecia Mix-souther |
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| Gender | Female |
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| Speciality | Emergency Medicine |
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| Experience | 8 Years |
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| Location | 1000 Oakland Dr, Kalamazoo, Michigan |
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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:
- Dr Samantha Alecia Mix-souther graduated from medical school in 2016
NPI Data:
- NPI Number: 1063816684
- Provider Enumeration Date: 10/09/2014
- Last Update Date: 12/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 6507153160
- Enrollment ID: I20220301002386
Medical Identifiers
Medical identifiers for Dr Samantha Alecia Mix-souther such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063816684 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 4301110346 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 4301110346 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Permanente Medical Group Inc | 8921910225 | 8376 |
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 Alecia Mix-souther allows following entities to bill medicare on her behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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 Alecia Mix-souther 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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Dr Samantha Alecia Mix-souther, MD
1000 Oakland Dr,
Kalamazoo, MI 49008-1282
Ph: (269) 337-4400 | Dr Samantha Alecia Mix-souther, MD
1000 Oakland Dr,
Kalamazoo, MI 49008-1282
Ph: (269) 337-4400 |
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