Mrs Samantha Sophia Peckham, AGACNP-BC in Las Vegas, NV

Mrs Samantha Sophia Peckham, AGACNP-BC is a medicare enrolled "Nurse Practitioner" in Las Vegas, Nevada. Her current practice location is 607 S Decatur Blvd, Las Vegas, Nevada. You can reach out to her office (for appointments etc.) via phone at (702) 822-7400.

Mrs Samantha Sophia Peckham is licensed to practice in Nevada (license number 001667) 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 1134546286.

Contact Information

	Mrs Samantha Sophia Peckham, AGACNP-BC
	607 S Decatur Blvd, Las Vegas, NV 89107-3912
	(702) 822-7400
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Samantha Sophia Peckham
Gender	Female
Speciality	Nurse Practitioner
Location	607 S Decatur Blvd, Las Vegas, Nevada
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134546286
Provider Enumeration Date: 03/26/2014
Last Update Date: 03/26/2014

Medicare PECOS Information:

PECOS PAC ID: 5092032011
Enrollment ID: I20150331001423

Medical Identifiers

Medical identifiers for Mrs Samantha Sophia Peckham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134546286	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	001667 (Nevada)	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 Samantha Sophia Peckham allows following entities to bill medicare on her behalf.

Entity Name	Fremont Emergency Services Scherr Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679550149 PECOS PAC ID: 4880684554 Enrollment ID: O20040514000465

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 Samantha Sophia Peckham 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
Mrs Samantha Sophia Peckham, AGACNP-BC 2927 Aqualine Ct, Las Vegas, NV 89117-2576 Ph: (702) 738-1775	Mrs Samantha Sophia Peckham, AGACNP-BC 607 S Decatur Blvd, Las Vegas, NV 89107-3912 Ph: (702) 822-7400

Reviews and Comments

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Mrs Samantha Sophia Peckham, AGACNP-BC - Medicare Nurse Practitioner in Las Vegas, NV