Dr Jacob Arthur Sambursky, MD - Medicare Psychiatry & Neurology in Fort Myers, FL

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Dr Jacob Arthur Sambursky, MD is a medicare enrolled "Psychiatry & Neurology - Neurology" physician in Fort Myers, Florida. His current practice location is 11215 Metro Pkwy Ste 1, Fort Myers, Florida. You can reach out to his office (for appointments etc.) via phone at (239) 208-2212.

Dr Jacob Arthur Sambursky is licensed to practice in Florida (license number ME163526) 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 1619436474.

Contact Information

Dr Jacob Arthur Sambursky, MD
11215 Metro Pkwy Ste 1,
Fort Myers, FL 33966-1206
(239) 208-2212
Not Available

Map and Direction




Physician's Profile

Full NameDr Jacob Arthur Sambursky
GenderMale
SpecialityPsychiatry & Neurology - Neurology
Location11215 Metro Pkwy Ste 1, Fort Myers, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1619436474
  • Provider Enumeration Date: 03/19/2019
  • Last Update Date: 06/16/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 2365806262
  • Enrollment ID: I20230911003764

Medical Identifiers

Medical identifiers for Dr Jacob Arthur Sambursky such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619436474NPI-NPPES
119994300MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208M00000XHospitalist ME163526 (Florida)Secondary
2084N0400XPsychiatry & Neurology - Neurology ME163526 (Florida)Primary
2084N0400XPsychiatry & Neurology - Neurology 2023050076 (Missouri)Secondary
2084N0400XPsychiatry & Neurology - Neurology 129103 (Montana)Secondary
2084N0400XPsychiatry & Neurology - Neurology MD220486 (Oregon)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. Dr Jacob Arthur Sambursky allows following entities to bill medicare on his behalf.
Entity NameConcord Hospital Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194778571
PECOS PAC ID: 6103721790
Enrollment ID: O20040405000916
Entity NameSt. Joseph Hospital Of Nashua Nh
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093787384
PECOS PAC ID: 2062455611
Enrollment ID: O20050606000515
Entity NameConcord Hospital-laconia
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053993741
PECOS PAC ID: 7012326259
Enrollment ID: O20210429001355
Entity NameConcord Hospital - Franklin
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1700960895
PECOS PAC ID: 4183033293
Enrollment ID: O20210504000723

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 Jacob Arthur Sambursky 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
Dr Jacob Arthur Sambursky, MD
Po Box 2147,
Fort Myers, FL 33902-2147

Ph: (239) 208-2212		Dr Jacob Arthur Sambursky, MD
11215 Metro Pkwy Ste 1,
Fort Myers, FL 33966-1206

Ph: (239) 208-2212

Reviews and Comments


Psychiatry & Neurology Doctors in Fort Myers, FL

Stanley Garken Lue, MD
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 11215 Metro Pkwy Ste 1, Fort Myers, FL 33966
Phone: 239-208-2212    Fax: 239-208-3994
Felix Gabriel Rivera - Perez, M.D.
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 11215 Metro Pkwy Ste 1, Fort Myers, FL 33966
Phone: 239-208-2212    
Erica Rene Wilt, M.D.
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 11215 Metro Pkwy Ste 100, Fort Myers, FL 33966
Phone: 239-208-2206    
Ellie Frazey, MD
Psychiatry & Neurology
Medicare: Medicare Enrolled
Practice Location: 11215 Metro Pkwy Ste 1, Fort Myers, FL 33966
Phone: 239-208-2212    
Dr. Mark Adam Giordano, M.D.
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 12550 New Brittany Blvd Ste 100, Fort Myers, FL 33907
Phone: 239-343-9180    Fax: 239-343-9188
Gustavo Silveira E Silva, M.D.
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 11215 Metro Pkwy Ste 100, Fort Myers, FL 33966
Phone: 239-208-2206    
Rachel Elizabeth Carlin, MD
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 11215 Metro Pkwy Ste 100, Fort Myers, FL 33966
Phone: 239-208-2212    

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.