Samantha Dawn Herman, MSN, APN, CPNP-PC is a medicare enrolled "Nurse Practitioner - Pediatrics" in Lake Luzerne, New York. Her current practice location is
27 Hyland Dr, Lake Luzerne, New York. You can reach out to her office (for appointments etc.) via phone at
(518) 824-2580.
Samantha Dawn Herman is licensed to practice in New York (license number F383312) 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 1508533951.
Provider's Profile
| Full Name | Samantha Dawn Herman |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Pediatrics |
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| Location | 27 Hyland Dr, Lake Luzerne, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1508533951
- Provider Enumeration Date: 08/24/2021
- Last Update Date: 10/24/2024
Medicare PECOS Information:
- PECOS PAC ID: 9335547546
- Enrollment ID: I20211001001100
Medical Identifiers
Medical identifiers for Samantha Dawn Herman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508533951 | NPI | - | NPPES |
| 06777444 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0200X | Nurse Practitioner - Pediatrics | F383312 (New York) | 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. Samantha Dawn Herman allows following entities to bill medicare on her behalf.
| Entity Name | Hudson Headwaters Health Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194738344
PECOS PAC ID: 7416861208
Enrollment ID: O20031117000239 |
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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. Samantha Dawn Herman 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 |
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Samantha Dawn Herman, MSN, APN, CPNP-PC
9 Carey Rd,
Queensbury, NY 12804-7880
Ph: (518) 761-0300 | Samantha Dawn Herman, MSN, APN, CPNP-PC
27 Hyland Dr,
Lake Luzerne, NY 12846-3923
Ph: (518) 824-2580 |
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