Samantha Jack, PA-C - Medicare Physician Assistant in Beavercreek, OH

Samantha Jack, PA-C is a medicare enrolled "Physician Assistant - Surgical" in Beavercreek, Ohio. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Wright State Physicians Inc and her current practice location is 725 University Blvd, Beavercreek, Ohio. You can reach out to her office (for appointments etc.) via phone at (937) 245-7150.

Samantha Jack is licensed to practice in Ohio (license number ) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1316314925.

Contact Information

Samantha Jack, PA-C
725 University Blvd,
Beavercreek, OH 45324-2640
(937) 245-7150
Not Available

Map and Direction




Provider's Profile

Full NameSamantha Jack
GenderFemale
SpecialityPhysician Assistant
Experience9 Years
Location725 University Blvd, Beavercreek, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Samantha Jack graduated from nursing school in 2015
  NPI Data:
  • NPI Number: 1316314925
  • Provider Enumeration Date: 08/31/2015
  • Last Update Date: 03/20/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 2466758982
  • Enrollment ID: I20160309002583

Medical Identifiers

Medical identifiers for Samantha Jack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316314925NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Miami Valley HospitalDayton, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Wright State Physicians Inc7618889320117

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 Jack 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
Samantha Jack, PA-C
725 University Blvd,
Beavercreek, OH 45324-2640

Ph: (937) 245-7150
Samantha Jack, PA-C
725 University Blvd,
Beavercreek, OH 45324-2640

Ph: (937) 245-7150

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.