Mr Samson Ebho Osebor, RN in Waltham, MA - Medicare Nurse Practitioner

Mr Samson Ebho Osebor, RN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Waltham, Massachusetts. His current practice location is 240 Bear Hill Rd Ste 104, Waltham, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (617) 340-3559.

Mr Samson Ebho Osebor is licensed to practice in Massachusetts (license number RN2311226) 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 1578298907.

Contact Information

	Mr Samson Ebho Osebor, RN
	240 Bear Hill Rd Ste 104, Waltham, MA 02451-1026
	(617) 340-3559
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Samson Ebho Osebor
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	240 Bear Hill Rd Ste 104, Waltham, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578298907
Provider Enumeration Date: 07/20/2022
Last Update Date: 03/11/2024

Medicare PECOS Information:

PECOS PAC ID: 0648717058
Enrollment ID: I20240802002654

Medical Identifiers

Medical identifiers for Mr Samson Ebho Osebor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578298907	NPI	-	NPPES
S92075712	Other	MA	DRIVER LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	RN2311226 (Massachusetts)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	RN2311226 (Massachusetts)	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. Mr Samson Ebho Osebor allows following entities to bill medicare on his behalf.

Entity Name	Alliance Wellcare Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790526986 PECOS PAC ID: 9739626144 Enrollment ID: O20240802002558

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. Mr Samson Ebho Osebor 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
Mr Samson Ebho Osebor, RN 667 Main St Apt 29, Woburn, MA 01801-2377 Ph: (781) 249-8007	Mr Samson Ebho Osebor, RN 240 Bear Hill Rd Ste 104, Waltham, MA 02451-1026 Ph: (617) 340-3559

Reviews and Comments

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Mr Samson Ebho Osebor, RN - Medicare Nurse Practitioner in Waltham, MA