Samara Acosta, is a medicare enrolled "Nurse Practitioner - Family" in Pearson, Georgia. Her current practice location is
640 Main St N, Pearson, Georgia. You can reach out to her office (for appointments etc.) via phone at
(912) 544-4569.
Samara Acosta is licensed to practice in Georgia (license number RN259547) 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 1205553112.
Provider's Profile
| Full Name | Samara Acosta |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 640 Main St N, Pearson, Georgia |
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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: 1205553112
- Provider Enumeration Date: 10/21/2022
- Last Update Date: 10/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 6305217092
- Enrollment ID: I20230117000310
Medical Identifiers
Medical identifiers for Samara Acosta such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205553112 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | RN259547 (Georgia) | 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. Samara Acosta allows following entities to bill medicare on her behalf.
| Entity Name | South Central Primary Care Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891978854
PECOS PAC ID: 1951395920
Enrollment ID: O20040413000249 |
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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. Samara Acosta 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 |
|---|
Samara Acosta,
1146 Oquinn Dr,
Tifton, GA 31794-3729
Ph: () - | Samara Acosta,
640 Main St N,
Pearson, GA 31642-7549
Ph: (912) 544-4569 |
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