Samantha Jewell Knobloch, APRN is a medicare enrolled "Nurse Practitioner - Neonatal" physician in New Haven, Connecticut. Her current practice location is
20 York St, New Haven, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(203) 715-5664.
Samantha Jewell Knobloch is licensed to practice in Connecticut (license number 11154) 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 1154049328.
Physician's Profile
| Full Name | Samantha Jewell Knobloch |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Neonatal |
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| Location | 20 York St, New Haven, Connecticut |
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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: 1154049328
- Provider Enumeration Date: 08/15/2022
- Last Update Date: 08/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 1759749286
- Enrollment ID: I20230615001311
Medical Identifiers
Medical identifiers for Samantha Jewell Knobloch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154049328 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | 11154 (Connecticut) | Secondary |
| 363LN0005X | Nurse Practitioner - Neonatal, Critical Care | 11154 (Connecticut) | Secondary |
| 363LN0000X | Nurse Practitioner - Neonatal | 11154 (Connecticut) | 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. Samantha Jewell Knobloch allows following entities to bill medicare on her behalf.
| Entity Name | Yale University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205822236
PECOS PAC ID: 9436061736
Enrollment ID: O20031105000015 |
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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. Samantha Jewell Knobloch 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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Samantha Jewell Knobloch, APRN
571 W River St,
Milford, CT 06461-1952
Ph: (203) 715-5664 | Samantha Jewell Knobloch, APRN
20 York St,
New Haven, CT 06510-3220
Ph: (203) 715-5664 |
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