Samantha Jerusal, - Medicare Nurse Practitioner in Chicago, IL

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Samantha Jerusal, is a medicare enrolled "Nurse Practitioner - Pediatrics" in Chicago, Illinois. Her current practice location is 2418 W Division St, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (312) 666-3494.

Samantha Jerusal is licensed to practice in Illinois (license number 209.028195) 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 1013610971.

Contact Information

Samantha Jerusal,
2418 W Division St,
Chicago, IL 60622-2940
(312) 666-3494
Not Available

Map and Direction




Provider's Profile

Full NameSamantha Jerusal
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location2418 W Division St, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1013610971
  • Provider Enumeration Date: 03/22/2023
  • Last Update Date: 09/05/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3274989553
  • Enrollment ID: I20231023001485

Medical Identifiers

Medical identifiers for Samantha Jerusal such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013610971NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WP0200XRegistered Nurse - Pediatrics 501051 (Ohio)Secondary
363LP0200XNurse Practitioner - Pediatrics 209.028195 (Illinois)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 Jerusal allows following entities to bill medicare on her behalf.
Entity NameErie Family Health Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760499545
PECOS PAC ID: 9537050422
Enrollment ID: O20040322000689

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 Jerusal 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 Jerusal,
2418 W Division St,
Chicago, IL 60622-2940

Ph: (312) 666-3494		Samantha Jerusal,
2418 W Division St,
Chicago, IL 60622-2940

Ph: (312) 666-3494

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).

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