Jennifer Sam, - Medicare Nurse Practitioner in Shelby Township, MI

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Jennifer Sam, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Shelby Township, Michigan. Her current practice location is 13045 Michael Dr, Shelby Township, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 225-1959.

Jennifer Sam is licensed to practice in Michigan (license number 4704248128) 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 1336405059.

Contact Information

Jennifer Sam,
13045 Michael Dr,
Shelby Township, MI 48315-4744
(248) 225-1959
Not Available

Map and Direction




Provider's Profile

Full NameJennifer Sam
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location13045 Michael Dr, Shelby Township, Michigan
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1336405059
  • Provider Enumeration Date: 04/06/2012
  • Last Update Date: 05/09/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3971757345
  • Enrollment ID: I20130212000397

Medical Identifiers

Medical identifiers for Jennifer Sam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336405059NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 4704248128 (Michigan)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 4704248128 (Michigan)Primary
363LA2200XNurse Practitioner - Adult Health 4704248128 (Michigan)Secondary

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. Jennifer Sam allows following entities to bill medicare on her behalf.
Entity NameAscension Eastwood Behavioral Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396787701
PECOS PAC ID: 2163324492
Enrollment ID: O20040126000572
Entity NameHenry Ford Macomb Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952440521
PECOS PAC ID: 7911808381
Enrollment ID: O20040617000651
Entity NameAscension Macomb Oakland Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578696092
PECOS PAC ID: 7315859725
Enrollment ID: O20041102000607
Entity NameCore Psych, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871069039
PECOS PAC ID: 8325384225
Enrollment ID: O20190115000198
Entity NameArman C Moshyedi Md Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700440203
PECOS PAC ID: 1658603576
Enrollment ID: O20191025002474

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. Jennifer Sam 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
Jennifer Sam,
13045 Michael Dr,
Shelby Township, MI 48315-3952

Ph: (248) 225-1959		Jennifer Sam,
13045 Michael Dr,
Shelby Township, MI 48315-4744

Ph: (248) 225-1959

Reviews and Comments


Nurse Practitioner Nurses in Shelby Township, MI

Russell Miller, CNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 50505 Schoenherr Rd, Ste. 340, Shelby Township, MI 48315
Phone: 586-731-8400    
Miss Joey Fattizzo, FNP, RN, RDH
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 45445 Mound Round, Suite 105, Shelby Township, MI 48317
Phone: 586-200-8707    Fax: 248-282-1313
Mrs. Karey Hartford, F.N.P.
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 49310 Van Dyke Ave, Shelby Township, MI 48317
Phone: 586-731-8900    Fax: 586-726-5439
Diana Scanlon, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 45640 Schoenherr Rd, Suite B, Shelby Township, MI 48315
Phone: 586-247-4300    Fax: 586-532-6496
Tyler Mclaughlan, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 14270 Oakwood Dr, Shelby Township, MI 48315
Phone: 586-900-9444    
Kathleen Lewis,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 46961 Van Dyke Ave, Shelby Township, MI 48317
Phone: 586-991-5205    
Theola J Rivera, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 8180 26 Mile Rd, Suite 100, Shelby Township, MI 48316
Phone: 586-336-7321    Fax: 586-336-7356

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.