Mrs Nisrin Abdelsamie, FNP - Medicare Nurse Practitioner in Montclair, CA

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Mrs Nisrin Abdelsamie, FNP is a medicare enrolled "Nurse Practitioner - Family" in Montclair, California. Her current practice location is 4950 San Bernardino St Ste 218, Montclair, California. You can reach out to her office (for appointments etc.) via phone at (714) 785-3495.

Mrs Nisrin Abdelsamie is licensed to practice in California (license number 95005663) 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 1104360627.

Contact Information

Mrs Nisrin Abdelsamie, FNP
4950 San Bernardino St Ste 218,
Montclair, CA 91763-2328
(714) 785-3495
Not Available

Map and Direction




Provider's Profile

Full NameMrs Nisrin Abdelsamie
GenderFemale
SpecialityNurse Practitioner - Family
Location4950 San Bernardino St Ste 218, Montclair, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104360627
  • Provider Enumeration Date: 12/19/2016
  • Last Update Date: 12/06/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2062798184
  • Enrollment ID: I20170404000647

Medical Identifiers

Medical identifiers for Mrs Nisrin Abdelsamie such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104360627NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 95005663 (California)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. Mrs Nisrin Abdelsamie allows following entities to bill medicare on her behalf.
Entity NameSouthern California Permanente Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678
Entity NameFaculty Physicians And Surgeons Of Llusm
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205009917
PECOS PAC ID: 1153227814
Enrollment ID: O20031211000981
Entity NameSouthern California Permanente Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823
Entity NamePih Health Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609233899
PECOS PAC ID: 8426951328
Enrollment ID: O20040128001177
Entity NameFaculty Physicians And Surgeons Of Llusm
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508255175
PECOS PAC ID: 1153227814
Enrollment ID: O20160216002196

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. Mrs Nisrin Abdelsamie 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
Mrs Nisrin Abdelsamie, FNP
4950 San Bernardino St Ste 218,
Montclair, CA 91763-2328

Ph: (714) 785-3495		Mrs Nisrin Abdelsamie, FNP
4950 San Bernardino St Ste 218,
Montclair, CA 91763-2328

Ph: (714) 785-3495

Reviews and Comments


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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.