Julie Lynn Samu Shouldice, OD is a medicare enrolled "Optometrist" provider in Indian River, Michigan. Her current practice location is
6494 Link Blvd, Indian River, Michigan. You can reach out to her office (for appointments etc.) via phone at
(313) 539-2020.
Julie Lynn Samu Shouldice is licensed to practice in Michigan (license number 4901004074) 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 1588742548.
Healthcare Provider's Profile
| Full Name | Julie Lynn Samu Shouldice |
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| Gender | Female |
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| Speciality | Optometrist |
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| Location | 6494 Link Blvd, Indian River, Michigan |
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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: 1588742548
- Provider Enumeration Date: 11/01/2006
- Last Update Date: 11/16/2016
Medicare PECOS Information:
- PECOS PAC ID: 1355436825
- Enrollment ID: I20070927000973
Medical Identifiers
Medical identifiers for Julie Lynn Samu Shouldice such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588742548 | NPI | - | NPPES |
| 0585020001 | Other | MI | ADMINASTAR |
| 4236737 | Medicaid | MI | |
| 0N16830 | Other | MI | MEDICARE PLUS BLUE |
| 4100442401 | Other | MI | RAILROAD MEDICARE |
| 900F965090 | Other | MI | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 4901004074 (Michigan) | 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. Julie Lynn Samu Shouldice allows following entities to bill medicare on her behalf.
| Provider Name | Eric J Siesel Od Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1407044688
PECOS PAC ID: 4486734225
Enrollment ID: O20080104000622 |
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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. Julie Lynn Samu Shouldice 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 |
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Julie Lynn Samu Shouldice, OD
6494 Link Blvd,
Indian River, MI 49749-9784
Ph: (313) 539-2020 | Julie Lynn Samu Shouldice, OD
6494 Link Blvd,
Indian River, MI 49749-9784
Ph: (313) 539-2020 |
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