Dr Samuel Mack Puckett, MD is a medicare enrolled "Pediatrics" physician in Newport, Tennessee. His current practice location is
1829 Crowe Ln, Newport, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 623-0653.
Dr Samuel Mack Puckett is licensed to practice in Tennessee (license number MD16317) 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 1770501819.
Physician's Profile
Full Name | Dr Samuel Mack Puckett |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 1829 Crowe Ln, Newport, Tennessee |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1770501819
- Provider Enumeration Date: 07/17/2006
- Last Update Date: 01/20/2010
Medicare PECOS Information:
- PECOS PAC ID: 5890709752
- Enrollment ID: I20060130000836
Medical Identifiers
Medical identifiers for Dr Samuel Mack Puckett such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1770501819 | NPI | - | NPPES |
3015182 | Medicaid | TN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | MD16317 (Tennessee) | 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 Samuel Mack Puckett allows following entities to bill medicare on his behalf.
Entity Name | Newport Pediatrics, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1467678706 PECOS PAC ID: 5294749248 Enrollment ID: O20060130000707 |
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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 Samuel Mack Puckett 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 Samuel Mack Puckett, MD 1829 Crowe Ln, Newport, TN 37821-7264 Ph: (423) 623-0653 | Dr Samuel Mack Puckett, MD 1829 Crowe Ln, Newport, TN 37821-7264 Ph: (423) 623-0653 |
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