Mr Samiollah Gholam, MD in Williston, VT - Medicare Internal Medicine

Mr Samiollah Gholam, MD is a medicare enrolled "Internal Medicine" physician in Williston, Vermont. His current practice location is 353 Blair Park Rd, Williston, Vermont. You can reach out to his office (for appointments etc.) via phone at (802) 847-1470.

Mr Samiollah Gholam is licensed to practice in Vermont (license number 042.0017590) 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 1326457904.

Contact Information

	Mr Samiollah Gholam, MD
	353 Blair Park Rd, Williston, VT 05495-7530
	(802) 847-1470
	Not Available

Map and Direction

Physician's Profile

Full Name	Mr Samiollah Gholam
Gender	Male
Speciality	Internal Medicine
Location	353 Blair Park Rd, Williston, Vermont
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1326457904
Provider Enumeration Date: 08/07/2014
Last Update Date: 03/27/2025

Medicare PECOS Information:

PECOS PAC ID: 4082971007
Enrollment ID: I20171129003702

Medical Identifiers

Medical identifiers for Mr Samiollah Gholam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326457904	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	042.0017590 (Vermont)	Primary
207R00000X	Internal Medicine	A145760 (California)	Secondary
207R00000X	Internal Medicine	MD60836207 (Washington)	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. Mr Samiollah Gholam allows following entities to bill medicare on his behalf.

Entity Name	Kern County Hospital Authority
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376623538 PECOS PAC ID: 4688964521 Enrollment ID: O20160915002690

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 Samiollah Gholam 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
Mr Samiollah Gholam, MD 1115 Se 164th Ave Dept 358, Vancouver, WA 98683-8004 Ph: (360) 729-1462	Mr Samiollah Gholam, MD 353 Blair Park Rd, Williston, VT 05495-7530 Ph: (802) 847-1470

Reviews and Comments

Internal Medicine Doctors in Williston, VT

Dr. Lucy Miller, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 353 Blair Park Rd, Williston, VT 05495 Phone: 802-847-1470
Dr. Dennis Armand Plante, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 353 Blair Park Rd, Williston, VT 05495 Phone: 802-847-1470 Fax: 802-847-7135
Dr. Marvin Klikunas, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 353 Blair Park Rd, Williston, VT 05495 Phone: 802-847-1470 Fax: 802-847-7135
Owen David Maguire, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 353 Blair Park Rd, Williston, VT 05495 Phone: 802-847-1470
Jonathan Benjamin Wilfong, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 353 Blair Park Rd, Williston, VT 05495 Phone: 802-847-1470 Fax: 802-847-7135
Anne E Brena, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 353 Blair Park Rd, Williston, VT 05495 Phone: 802-847-1470

Mr Samiollah Gholam, MD - Medicare Internal Medicine in Williston, VT