Samantha Rose Kauchak, FNP in Rockford, IL - Medicare Nurse Practitioner

Samantha Rose Kauchak, FNP is a medicare enrolled "Nurse Practitioner" in Rockford, Illinois. Her current practice location is 1253 N Alpine Rd, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (779) 696-8400.

Samantha Rose Kauchak is licensed to practice in Illinois (license number 209026147) 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 1689398521.

Contact Information

	Samantha Rose Kauchak, FNP
	1253 N Alpine Rd, Rockford, IL 61107-2201
	(779) 696-8400
	Not Available

Map and Direction

Provider's Profile

Full Name	Samantha Rose Kauchak
Gender	Female
Speciality	Nurse Practitioner
Location	1253 N Alpine Rd, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689398521
Provider Enumeration Date: 10/03/2022
Last Update Date: 11/04/2022

Medicare PECOS Information:

PECOS PAC ID: 7214307024
Enrollment ID: I20230111002318

Medical Identifiers

Medical identifiers for Samantha Rose Kauchak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689398521	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	041428462 (Illinois)	Secondary
363L00000X	Nurse Practitioner	209026147 (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 Rose Kauchak allows following entities to bill medicare on her behalf.

Entity Name	Swedishamerican Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962451732 PECOS PAC ID: 5799698346 Enrollment ID: O20031215000012

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 Rose Kauchak 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
Samantha Rose Kauchak, FNP 3684 Valerie Rd, Roscoe, IL 61073-8916 Ph: (815) 621-4209	Samantha Rose Kauchak, FNP 1253 N Alpine Rd, Rockford, IL 61107-2201 Ph: (779) 696-8400

Reviews and Comments

Nurse Practitioner Nurses in Rockford, IL

Misty Lynn Dehaven, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1639 N Alpine Rd Ste 260, Rockford, IL 61107 Phone: 815-395-1500 Fax: 815-395-1415
Candice Vicencio, DNP, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4215 Newburg Rd, Rockford, IL 61108 Phone: 815-988-8500 Fax: 815-977-5956
Caryn Ann Ruzic, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600 Fax: 815-490-1881
Tyler James Rafferty, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5666 E State St, Rockford, IL 61108 Phone: 815-226-2000
Angela Giardono, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5666 E State St, Rockford, IL 61108 Phone: 815-226-2000
Melissa L. Inman, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 461 N Mulford Rd Ste 3, Rockford, IL 61107 Phone: 815-227-9594 Fax: 815-227-9574
Michelle L Bennett, APRN Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 3505 N Bell School Rd, Rockford, IL 61114 Phone: 779-696-0300 Fax: 815-639-9433

Samantha Rose Kauchak, FNP - Medicare Nurse Practitioner in Rockford, IL