Samantha Ellen Pederson, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Lincoln, Nebraska. Her current practice location is
5200 S 56th St Ste 2, Lincoln, Nebraska. You can reach out to her office (for appointments etc.) via phone at
(402) 421-6200.
Samantha Ellen Pederson is licensed to practice in Nebraska (license number 2565) 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 1033885504.
Physician's Profile
Full Name | Samantha Ellen Pederson |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 5200 S 56th St Ste 2, Lincoln, Nebraska |
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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: 1033885504
- Provider Enumeration Date: 08/17/2021
- Last Update Date: 09/01/2022
Medicare PECOS Information:
- PECOS PAC ID: 9133525934
- Enrollment ID: I20210902000662
Medical Identifiers
Medical identifiers for Samantha Ellen Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1033885504 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 2565 (Nebraska) | Secondary |
363AM0700X | Physician Assistant - Medical | 2565 (Nebraska) | Primary |
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. Samantha Ellen Pederson 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 |
Samantha Ellen Pederson, PA-C 5200 S 56th St Ste 2, Lincoln, NE 68516-1891 Ph: (402) 421-6200 | Samantha Ellen Pederson, PA-C 5200 S 56th St Ste 2, Lincoln, NE 68516-1891 Ph: (402) 421-6200 |
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