Dr Samuel Ernest Logan, MD, PHD is a medicare enrolled "Plastic Surgery" physician in Saint Joseph, Michigan. His current practice location is
3901 Stonegate Park, Suite 300, Saint Joseph, Michigan. You can reach out to his office (for appointments etc.) via phone at
(269) 556-6000.
Dr Samuel Ernest Logan is licensed to practice in Michigan (license number 4301056980) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013914241.
Physician's Profile
Full Name | Dr Samuel Ernest Logan |
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Gender | Male |
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Speciality | Plastic Surgery |
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Location | 3901 Stonegate Park, Saint Joseph, Michigan |
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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: 1013914241
- Provider Enumeration Date: 07/01/2005
- Last Update Date: 01/31/2017
Medicare PECOS Information:
- PECOS PAC ID: 3274712427
- Enrollment ID: I20110120000695
Medical Identifiers
Medical identifiers for Dr Samuel Ernest Logan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013914241 | NPI | - | NPPES |
2663684 | Medicaid | MI | |
1013914241 | Medicaid | MI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208200000X | Plastic Surgery | 4301056980 (Michigan) | Primary |
2082S0105X | Plastic Surgery - Surgery Of The Hand | 4301056980 (Michigan) | Secondary |
174400000X | Specialist | 4301056980 (Michigan) | Secondary |
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 Ernest Logan allows following entities to bill medicare on his behalf.
Entity Name | Lakeland Medical Practices |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1538397120 PECOS PAC ID: 1658427042 Enrollment ID: O20090928000216 |
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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 Ernest Logan 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 Samuel Ernest Logan, MD, PHD 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 Ph: (269) 556-6000 | Dr Samuel Ernest Logan, MD, PHD 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 Ph: (269) 556-6000 |
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