Dr Samuel Blake Ecker, DO is a medicare enrolled "Dermatology" physician in Laramie, Wyoming. He went to Arizona College Of Osteopathic Medicine Mid Western University and graduated in 2013 and has 11 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Sage Dermatology Llc, Sage Dermatology Llc and his current practice location is
204 Mccollum St Ste 106e, Laramie, Wyoming. You can reach out to his office (for appointments etc.) via phone at
(970) 682-3377.
Dr Samuel Blake Ecker is licensed to practice in Colorado (license number 0061328) 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 1033555230.
Physician's Profile
| Full Name | Dr Samuel Blake Ecker |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 11 Years |
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| Location | 204 Mccollum St Ste 106e, Laramie, Wyoming |
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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:
- Dr Samuel Blake Ecker attended and graduated from Arizona College Of Osteopathic Medicine Mid Western University in 2013
NPI Data:
- NPI Number: 1033555230
- Provider Enumeration Date: 05/14/2013
- Last Update Date: 09/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 6305112509
- Enrollment ID: I20190129002988
Medical Identifiers
Medical identifiers for Dr Samuel Blake Ecker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1033555230 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 6858A (Wyoming) | Secondary |
| 207N00000X | Dermatology | 0061328 (Colorado) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Sage Dermatology Llc | 2365840824 | 5 |
| Sage Dermatology Llc | 2365840824 | 5 |
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 Samuel Blake Ecker allows following entities to bill medicare on his behalf.
| Entity Name | Sage Dermatology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255002101
PECOS PAC ID: 2365840824
Enrollment ID: O20211013002764 |
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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 Samuel Blake Ecker 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 Samuel Blake Ecker, DO
2710 Westridge Ct,
Fort Collins, CO 80526-6503
Ph: (970) 682-3377 | Dr Samuel Blake Ecker, DO
204 Mccollum St Ste 106e,
Laramie, WY 82070-5151
Ph: (970) 682-3377 |
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