Samuel R Davis, MD is a medicare enrolled "Radiology - Vascular & Interventional Radiology" physician in Montgomery, West Virginia. His current practice location is
400 6th Ave, Montgomery, West Virginia. You can reach out to his office (for appointments etc.) via phone at
(304) 442-5151.
Samuel R Davis is licensed to practice in West Virginia (license number 13914) 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 1902863954.
Physician's Profile
| Full Name | Samuel R Davis |
|---|
| Gender | Male |
|---|
| Speciality | Radiology - Vascular & Interventional Radiology |
|---|
| Location | 400 6th Ave, Montgomery, West Virginia |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1902863954
- Provider Enumeration Date: 04/26/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5294648697
- Enrollment ID: I20031112000471
Medical Identifiers
Medical identifiers for Samuel R Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902863954 | NPI | - | NPPES |
| 0117385000 | Medicaid | WV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 13914 (West 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. Samuel R Davis allows following entities to bill medicare on his behalf.
| Entity Name | Montgomery General Hospital, Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1619913647
PECOS PAC ID: 6204735269
Enrollment ID: O20040108000241 |
|---|
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 R Davis 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 R Davis, MD
400 6th Ave,
Montgomery, WV 25136-2117
Ph: (304) 442-5151 | Samuel R Davis, MD
400 6th Ave,
Montgomery, WV 25136-2117
Ph: (304) 442-5151 |
Reviews and Comments