Dr Samuel Michael Theagene, MD is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Laurelton, New York. He graduated from medical school in 1990 and has 35 years of diverse experience with area of expertise as Pain Management. His current practice location is
22422 Merrick Blvd, Laurelton, New York. You can reach out to his office (for appointments etc.) via phone at
(347) 270-8353.
Dr Samuel Michael Theagene is licensed to practice in New York (license number 194218) 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 1518928167.
Physician's Profile
| Full Name | Dr Samuel Michael Theagene |
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| Gender | Male |
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| Speciality | Pain Management |
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| Experience | 35 Years |
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| Location | 22422 Merrick Blvd, Laurelton, New York |
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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 Michael Theagene graduated from medical school in 1990
NPI Data:
- NPI Number: 1518928167
- Provider Enumeration Date: 03/31/2006
- Last Update Date: 03/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 2264411560
- Enrollment ID: I20110427000214
Medical Identifiers
Medical identifiers for Dr Samuel Michael Theagene such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518928167 | NPI | - | NPPES |
| G400043923 | Other | NY | PTAN |
| 135761803 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 194218 (New York) | Primary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | 194218 (New York) | 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 Michael Theagene allows following entities to bill medicare on his behalf.
| Entity Name | Central Park Physical Medicine Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174848501
PECOS PAC ID: 5890979777
Enrollment ID: O20110419000129 |
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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 Michael Theagene 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 Michael Theagene, MD
22422 Merrick Blvd,
Laurelton, NY 11413-2023
Ph: (347) 270-8353 | Dr Samuel Michael Theagene, MD
22422 Merrick Blvd,
Laurelton, NY 11413-2023
Ph: (347) 270-8353 |
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