Samantha T Suttles, AGACNP is a medicare enrolled "Nurse Practitioner - Family" in Centerville, Indiana. Her current practice location is
4282 Lamott Rd, Centerville, Indiana. You can reach out to her office (for appointments etc.) via phone at
(765) 277-3951.
Samantha T Suttles is licensed to practice in Indiana (license number 1205674058) 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 1205674058.
Provider's Profile
Full Name | Samantha T Suttles |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 4282 Lamott Rd, Centerville, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205674058
- Provider Enumeration Date: 07/16/2024
- Last Update Date: 10/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 7517499155
- Enrollment ID: I20241021001530
Medical Identifiers
Medical identifiers for Samantha T Suttles such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205674058 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 1205674058 (Indiana) | 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 T Suttles allows following entities to bill medicare on her behalf.
Entity Name | Extended Care Specialists, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20050318000726 |
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Entity Name | Nora Urgent Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033548896 PECOS PAC ID: 4486884871 Enrollment ID: O20140304001685 |
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Entity Name | Eventus Wholehealth Midwest Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1386252757 PECOS PAC ID: 4183040470 Enrollment ID: O20200818000277 |
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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 T Suttles 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 T Suttles, AGACNP 4282 Lamott Rd, Centerville, IN 47330-9647 Ph: (765) 277-3951 | Samantha T Suttles, AGACNP 4282 Lamott Rd, Centerville, IN 47330-9647 Ph: (765) 277-3951 |
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