Dr Samuel Lessley Ardis Douglas, MD is a medicare enrolled "Surgery - Surgical Oncology" physician in Mountain Brk, Alabama. He graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Surgical Oncology. He is a member of the group practice University Hospitals Medical Group Inc and his current practice location is
500 Office Park Dr Ste 400, Mountain Brk, Alabama. You can reach out to his office (for appointments etc.) via phone at
(205) 803-4384.
Dr Samuel Lessley Ardis Douglas is licensed to practice in Alabama (license number 34727) 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 1811308257.
Physician's Profile
| Full Name | Dr Samuel Lessley Ardis Douglas |
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| Gender | Male |
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| Speciality | Surgical Oncology |
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| Experience | 10 Years |
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| Location | 500 Office Park Dr Ste 400, Mountain Brk, Alabama |
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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 Lessley Ardis Douglas graduated from medical school in 2014
NPI Data:
- NPI Number: 1811308257
- Provider Enumeration Date: 05/19/2014
- Last Update Date: 10/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 3971835083
- Enrollment ID: I20230811002917
Medical Identifiers
Medical identifiers for Dr Samuel Lessley Ardis Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811308257 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2086X0206X | Surgery - Surgical Oncology | 34727 (Alabama) | Primary |
| 208600000X | Surgery | 34727 (Alabama) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| University Hospitals Medical Group Inc | 4789682493 | 1542 |
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 Lessley Ardis Douglas allows following entities to bill medicare on his behalf.
| Entity Name | University Hospitals Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669499414
PECOS PAC ID: 4789682493
Enrollment ID: O20061113000301 |
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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 Lessley Ardis Douglas 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 Lessley Ardis Douglas, MD
500 Office Park Dr Ste 400,
Mountain Brk, AL 35223-2457
Ph: (205) 803-4384 | Dr Samuel Lessley Ardis Douglas, MD
500 Office Park Dr Ste 400,
Mountain Brk, AL 35223-2457
Ph: (205) 803-4384 |
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