Dr Samantha Monique Black, MD in Bedford, TX

Dr Samantha Monique Black, MD is a medicare enrolled "Dermatology" physician in Bedford, Texas. Her current practice location is 1615 Hospital Pkwy Ste 306, Bedford, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 684-5100.

Dr Samantha Monique Black is licensed to practice in Texas (license number V6875) 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 1891375465.

Contact Information

	Dr Samantha Monique Black, MD
	1615 Hospital Pkwy Ste 306, Bedford, TX 76022-5936
	(817) 684-5100
	(817) 684-5101

Map and Direction

Physician's Profile

Full Name	Dr Samantha Monique Black
Gender	Female
Speciality	Dermatology
Location	1615 Hospital Pkwy Ste 306, Bedford, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891375465
Provider Enumeration Date: 04/08/2021
Last Update Date: 04/07/2025

Medicare PECOS Information:

PECOS PAC ID: 2769907260
Enrollment ID: I20250417000366

Medical Identifiers

Medical identifiers for Dr Samantha Monique Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891375465	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	V6875 (Texas)	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 Monique Black allows following entities to bill medicare on her behalf.

Entity Name	Epiphany Dermatology Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043615263 PECOS PAC ID: 3971827791 Enrollment ID: O20150126001498

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 Monique 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 Monique Black, MD 7300 Ranch Road 2222, Bldg 1, Ste 200, Austin, TX 78730-3255 Ph: (512) 628-0465	Dr Samantha Monique Black, MD 1615 Hospital Pkwy Ste 306, Bedford, TX 76022-5936 Ph: (817) 684-5100

Reviews and Comments

Dermatology Doctors in Bedford, TX

Shaun Daniel Cooper, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1600 Central Dr Ste 158, Bedford, TX 76022 Phone: 817-736-2912 Fax: 817-736-2912
George C Baker, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1615 Hospital Parkway, Suite 306, Bedford, TX 76022 Phone: 817-684-5106 Fax: 817-684-5120
Calvin Lamont Williams, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1600 Central Drive, Ste 158, Bedford, TX 76022 Phone: 817-736-2912 Fax: 817-736-2912
John David Miller, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1615 Hospital Parkway, Suite 306, Bedford, TX 76022 Phone: 817-684-5106 Fax: 817-684-5120
Dr. Jorge Roman, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1615 Hospital Pkwy Ste 306, Bedford, TX 76022 Phone: 817-684-5100 Fax: 817-259-2754
Dr. Christopher Kenton Fuller, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1615 Hospital Pkwy Ste 306, Bedford, TX 76022 Phone: 817-684-5100 Fax: 817-684-5101

Dr Samantha Monique Black, MD - Medicare Dermatology in Bedford, TX