Samuel Fitzsimons Ravenel Ii, MD is a medicare enrolled "Pediatrics" physician in Cantonment, Florida. His current practice location is
470 S Highway 29 Ste 2, Cantonment, Florida. You can reach out to his office (for appointments etc.) via phone at
(850) 780-0111.
Samuel Fitzsimons Ravenel Ii is licensed to practice in Florida (license number ME128058) 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 1184679375.
Physician's Profile
Full Name | Samuel Fitzsimons Ravenel Ii |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 470 S Highway 29 Ste 2, Cantonment, Florida |
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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: 1184679375
- Provider Enumeration Date: 05/24/2006
- Last Update Date: 09/24/2019
Medicare PECOS Information:
- PECOS PAC ID: 3173592961
- Enrollment ID: I20180816001007
Medical Identifiers
Medical identifiers for Samuel Fitzsimons Ravenel Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184679375 | NPI | - | NPPES |
017919600 | Medicaid | FL | |
M8P04 | Other | FL | BCBS FL |
KD915 | Other | FL | MCR FL |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | ME128058 (Florida) | 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 Fitzsimons Ravenel Ii allows following entities to bill medicare on his behalf.
Entity Name | Escambia Community Clinics Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1518971597 PECOS PAC ID: 9638165806 Enrollment ID: O20040422001135 |
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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. Samuel Fitzsimons Ravenel Ii 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 |
Samuel Fitzsimons Ravenel Ii, MD 2315 W Jackson St, Pensacola, FL 32505-7552 Ph: (850) 436-4630 | Samuel Fitzsimons Ravenel Ii, MD 470 S Highway 29 Ste 2, Cantonment, FL 32533-6314 Ph: (850) 780-0111 |
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