Jennifer Herberger Samuel, NP-BC is a medicare enrolled "Nurse Practitioner - Family" physician in Leesburg, Virginia. Her current practice location is
531 E Market St, Leesburg, Virginia. You can reach out to her office (for appointments etc.) via phone at
(301) 428-1070.
Jennifer Herberger Samuel is licensed to practice in Virginia (license number 0024186818) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1689350977.
Physician's Profile
| Full Name | Jennifer Herberger Samuel |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 531 E Market St, Leesburg, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689350977
- Provider Enumeration Date: 06/22/2023
- Last Update Date: 10/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 3173986429
- Enrollment ID: I20230905000177
Medical Identifiers
Medical identifiers for Jennifer Herberger Samuel such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689350977 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 0024186818 (Virginia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 0024186818 (Virginia) | Primary |
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. Jennifer Herberger Samuel allows following entities to bill medicare on her behalf.
| Entity Name | Inova Ucc Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508592114
PECOS PAC ID: 7012385040
Enrollment ID: O20221123001904 |
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| Entity Name | Tru Health Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194471946
PECOS PAC ID: 6406216183
Enrollment ID: O20230712004006 |
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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. Jennifer Herberger Samuel 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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Jennifer Herberger Samuel, NP-BC
20730 Ruffsdale Ct,
Ashburn, VA 20147-2843
Ph: (571) 212-2614 | Jennifer Herberger Samuel, NP-BC
531 E Market St,
Leesburg, VA 20176-4115
Ph: (301) 428-1070 |
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