Jacob Sampson, PT in Indianapolis, IN - Medicare Physical Therapist Provider

Jacob Sampson, PT is a medicare enrolled "Physical Therapist" provider in Indianapolis, Indiana. His current practice location is 5641 Crawfordsville Rd, Indianapolis, Indiana. You can reach out to his office (for appointments etc.) via phone at (317) 524-8570.

Jacob Sampson is licensed to practice in Indiana (license number 05015279A) 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 1639954134.

Contact Information

	Jacob Sampson, PT
	5641 Crawfordsville Rd, Indianapolis, IN 46224-3718
	(317) 524-8570
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jacob Sampson
Gender	Male
Speciality	Physical Therapist
Location	5641 Crawfordsville Rd, Indianapolis, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639954134
Provider Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023

Medicare PECOS Information:

PECOS PAC ID: 5193176618
Enrollment ID: I20240109004456

Medical Identifiers

Medical identifiers for Jacob Sampson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639954134	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	05015279A (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. Jacob Sampson allows following entities to bill medicare on his behalf.

Provider Name	Fast Track Physical Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1992005540 PECOS PAC ID: 7517148745 Enrollment ID: O20150612002412

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. Jacob Sampson 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
Jacob Sampson, PT 9082 E Us Highway 36, Avon, IN 46123-7780 Ph: (131) 752-4857	Jacob Sampson, PT 5641 Crawfordsville Rd, Indianapolis, IN 46224-3718 Ph: (317) 524-8570

Reviews and Comments

Physical Therapist in Indianapolis, IN

Kristene Marie Corbin, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5936 N Keystone Ave, Indianapolis, IN 46220 Phone: 317-257-8340
Steven Saied, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9480 Priority Way West Dr, Indianapolis, IN 46240 Phone: 317-818-0570
Marycharlotte Turner Bales, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 426 S Alabama St Ste 200, Indianapolis, IN 46225 Phone: 317-528-6804 Fax: 317-528-3781
Lisa Smiley, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4340 W 96th St Ste 105a, Indianapolis, IN 46268 Phone: 317-660-1999 Fax: 317-660-1870
Alyssa Bettag, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7701 E 21st St, Indianapolis, IN 46219 Phone: 317-329-1000
Kristin Leigh Roth, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5515 W 38th St, Indianapolis, IN 46254 Phone: 317-880-0282 Fax: 317-880-0296
Lisa M Oldham, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1701 Senate Blvd, Suite Ag045, Indianapolis, IN 46202 Phone: 317-962-4836 Fax: 317-962-4812

Jacob Sampson, PT - Medicare Physical Therapist in Indianapolis, IN