Samuel Douglass, DO - Medicare Radiology in Fort Gordon, GA

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Samuel Douglass, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Fort Gordon, Georgia. His current practice location is 300 W Hospital Rd, Fort Gordon, Georgia. You can reach out to his office (for appointments etc.) via phone at (706) 787-2175.

Samuel Douglass is licensed to practice in Nebraska (license number 1539) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063801678.

Contact Information

Samuel Douglass, DO
300 W Hospital Rd,
Fort Gordon, GA 30905-5741
(706) 787-2175
Not Available

Map and Direction




Physician's Profile

Full NameSamuel Douglass
GenderMale
SpecialityRadiology - Diagnostic Radiology
Location300 W Hospital Rd, Fort Gordon, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063801678
  • Provider Enumeration Date: 01/20/2015
  • Last Update Date: 08/30/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6103106091
  • Enrollment ID: I20210924000787

Medical Identifiers

Medical identifiers for Samuel Douglass such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063801678NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology OP61322937 (Washington)Secondary
2085R0202XRadiology - Diagnostic Radiology 1539 (Nebraska)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. Samuel Douglass allows following entities to bill medicare on his behalf.
Entity NameSouth Georgia Radiology Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760669931
PECOS PAC ID: 0042389231
Enrollment ID: O20080514000110
Entity NameMedical Imaging Northwest - Good Samaritan Hospital Imaging Alliance
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083802946
PECOS PAC ID: 3375603970
Enrollment ID: O20220803002181
Entity NameUnion Avenue Open Mri Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568531242
PECOS PAC ID: 5597652917
Enrollment ID: O20220807000124
Entity NameTra-minw P S
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396814166
PECOS PAC ID: 2163316167
Enrollment ID: O20221208000505

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. Samuel Douglass 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 AddressPractice Location Address
Samuel Douglass, DO
9040 Fitzsimmons Dr,
Joint Base Lewis Mcchord, WA 98431-1000

Ph: (253) 968-0369		Samuel Douglass, DO
300 W Hospital Rd,
Fort Gordon, GA 30905-5741

Ph: (706) 787-2175

Reviews and Comments


Radiology Doctors in Fort Gordon, GA

Dr. Christopher Bazemore, D.O.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905
Phone: 706-787-1174    
Dr. Christopher Looney, M.D.
Radiology
Medicare: Medicare Enrolled
Practice Location: 300 E Hospital Road, Fort Gordon, GA 30905
Phone: 706-787-4501    
Dr. Michael James Kelly, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 300 W Hospital Rd, Eisenhower Army Medical Center, Fort Gordon, GA 30905
Phone: 504-319-6598    
Dr. Bruce Lee James, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905
Phone: 706-787-6245    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.