Samuel Harry Van Rensburg, PMHNP-BC - Medicare Nurse Practitioner in Taylorsville, UT

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Samuel Harry Van Rensburg, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Taylorsville, Utah. His current practice location is 5770 S 1500 W, Taylorsville, Utah. You can reach out to his office (for appointments etc.) via phone at (203) 343-9490.

Samuel Harry Van Rensburg is licensed to practice in Utah (license number 11839389-4405) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063067346.

Contact Information

Samuel Harry Van Rensburg, PMHNP-BC
5770 S 1500 W,
Taylorsville, UT 84123-5216
(203) 343-9490
Not Available

Map and Direction




Provider's Profile

Full NameSamuel Harry Van Rensburg
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location5770 S 1500 W, Taylorsville, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063067346
  • Provider Enumeration Date: 08/05/2019
  • Last Update Date: 08/10/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2769712967
  • Enrollment ID: I20191002000819

Medical Identifiers

Medical identifiers for Samuel Harry Van Rensburg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063067346NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology APRN02110 (Rhode Island)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 11839389-4405 (Utah)Primary
363LA2200XNurse Practitioner - Adult Health 11839389-4409 (Utah)Secondary
363LG0600XNurse Practitioner - Gerontology 11839389-4409 (Utah)Secondary

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. Samuel Harry Van Rensburg allows following entities to bill medicare on his behalf.
Entity NameThundermist Health Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700041001
PECOS PAC ID: 1557270477
Enrollment ID: O20040211000909

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. Samuel Harry Van Rensburg 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
Samuel Harry Van Rensburg, PMHNP-BC
5770 S 1500 W Bldg G,
Salt Lake City, UT 84123-5216

Ph: (801) 313-7770		Samuel Harry Van Rensburg, PMHNP-BC
5770 S 1500 W,
Taylorsville, UT 84123-5216

Ph: (203) 343-9490

Reviews and Comments


Nurse Practitioner Nurses in Taylorsville, UT

Mrs. Paige Jolynn Stodtmeister, PMHNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 5770 S 1500 W, Taylorsville, UT 84123
Phone: 801-313-7711    
Janice Lamborn, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3845 W 4700 S, Taylorsville, UT 84118
Phone: 801-840-2101    
Lisa Ann Ostrander, AGNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1385 W 2200 S, Taylorsville, UT 84119
Phone: 801-944-0095    
Devin James Slade, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 4970 S 3535 W, Taylorsville, UT 84129
Phone: 801-822-3975    
Florence Fairbanks, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 5770 S 1500 W, Taylorsville, UT 84123
Phone: 801-265-3144    
Miss Cheryl Scholes, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 5770 S 1500 W, Taylorsville, UT 84123
Phone: 801-313-7800    

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.