Mr Sidary Sam, MSW is a medicare enrolled "Social Worker - Clinical" provider in Long Beach, California. He graduated from healthcare school in 2007 and has 19 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Community Medical Wellness Centers Usa and his current practice location is
4510 E Pacific Coast Hwy Ste 600, Long Beach, California. You can reach out to his office (for appointments etc.) via phone at
(562) 346-1100.
Mr Sidary Sam is licensed to practice in California (license number LCSW94013) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1962557900.
Healthcare Provider's Profile
| Full Name | Mr Sidary Sam |
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| Gender | Male |
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| Speciality | Clinical Social Worker |
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| Experience | 19 Years |
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| Location | 4510 E Pacific Coast Hwy Ste 600, Long Beach, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Sidary Sam graduated from medical school in 2007
NPI Data:
- NPI Number: 1962557900
- Provider Enumeration Date: 01/23/2007
- Last Update Date: 03/08/2021
Medicare PECOS Information:
- PECOS PAC ID: 2466970793
- Enrollment ID: I20250527001727
Medical Identifiers
Medical identifiers for Mr Sidary Sam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962557900 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | ASW 22278 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW94013 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Community Medical Wellness Centers Usa | 1759665367 | 29 |
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. Mr Sidary Sam allows following entities to bill medicare on his behalf.
| Entity Name | Community Medical Wellness Centers Usa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235500513
PECOS PAC ID: 1759665367
Enrollment ID: O20170227002197 |
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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. Mr Sidary Sam 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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Mr Sidary Sam, MSW
4510 E Pacific Coast Hwy Ste 600,
Long Beach, CA 90804-6914
Ph: (562) 346-1100 | Mr Sidary Sam, MSW
4510 E Pacific Coast Hwy Ste 600,
Long Beach, CA 90804-6914
Ph: (562) 346-1100 |
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