Dr Samantha Black, PSYD is a medicare enrolled "Psychologist" provider in Columbus, Ohio. Her current practice location is
2238 S Hamilton Rd Ste 200, Columbus, Ohio. You can reach out to her office (for appointments etc.) via phone at
(740) 751-0042.
Dr Samantha Black is licensed to practice in Ohio (license number 08687) 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 1811568025.
Healthcare Provider's Profile
| Full Name | Dr Samantha Black |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 2238 S Hamilton Rd Ste 200, Columbus, Ohio |
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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: 1811568025
- Provider Enumeration Date: 07/08/2021
- Last Update Date: 09/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 3870029358
- Enrollment ID: I20241206002200
Medical Identifiers
Medical identifiers for Dr Samantha Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811568025 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 08687 (Ohio) | 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. Dr Samantha Black allows following entities to bill medicare on her behalf.
| Entity Name | Mid-ohio Psychological Services, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699749457
PECOS PAC ID: 3577585819
Enrollment ID: O20160509001255 |
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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. Dr Samantha Black 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 |
|---|
Dr Samantha Black, PSYD
106 Starret St Ste 100,
Lancaster, OH 43130-3993
Ph: (740) 687-0042 | Dr Samantha Black, PSYD
2238 S Hamilton Rd Ste 200,
Columbus, OH 43232-4382
Ph: (740) 751-0042 |
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