Mr Samuel David South, MD - Medicare General Surgery in Saint Paul, MN

  1. Home
  2. Surgery
  3. MN
  4. Saint Paul
Mr Samuel David South, MD is a medicare enrolled "Surgery" physician in Saint Paul, Minnesota. He went to University Of Utah School Of Medicine and graduated in 2013 and has 13 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Poudre Valley Medical Group Llc and his current practice location is 640 Jackson St, Saint Paul, Minnesota. You can reach out to his office (for appointments etc.) via phone at (952) 967-7977.

Mr Samuel David South is licensed to practice in Minnesota (license number 83232) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154664282.

Contact Information

Mr Samuel David South, MD
640 Jackson St,
Saint Paul, MN 55101-2502
(952) 967-7977
(651) 254-7990

Map and Direction




Physician's Profile

Full NameMr Samuel David South
GenderMale
SpecialityGeneral Surgery
Experience13 Years
Location640 Jackson St, Saint Paul, Minnesota
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Samuel David South attended and graduated from University Of Utah School Of Medicine in 2013
  NPI Data:
  • NPI Number: 1154664282
  • Provider Enumeration Date: 03/27/2013
  • Last Update Date: 09/23/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 7911202122
  • Enrollment ID: I20220813000120

Medical Identifiers

Medical identifiers for Mr Samuel David South such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154664282NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery DR.0068718 (Colorado)Secondary
208600000XSurgery 83232 (Minnesota)Primary
208600000XSurgery 5267810-1205 (Utah)Secondary
2086S0102XSurgery - Surgical Critical Care 5267810-1205 (Utah)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
University Colo Health Memorial Hospital CentralColorado springs, COHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Poudre Valley Medical Group Llc96382085492425

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 Samuel David South allows following entities to bill medicare on his behalf.
Entity NamePoudre Valley Medical Group LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225356868
PECOS PAC ID: 9638208549
Enrollment ID: O20100602000122

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 Samuel David South 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
Mr Samuel David South, MD
8170 33rd Ave S # Ms 21110q,
Bloomington, MN 55425-4516

Ph: Not Available		Mr Samuel David South, MD
640 Jackson St,
Saint Paul, MN 55101-2502

Ph: (952) 967-7977

Reviews and Comments


Surgery Doctors in Saint Paul, MN

Juan Jose Blondet Teixeira, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 280 Smith Ave N, Suite 700, Saint Paul, MN 55102
Phone: 651-241-6600    
Brian S Myer, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 640 Jackson St # Ms 11502v, Saint Paul, MN 55101
Phone: 651-254-7980    Fax: 651-254-7990
Dr. James Adam Davis, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 225 Smith Ave N, Ste. 400, Saint Paul, MN 55102
Phone: 651-290-0133    
Richard S Gregory, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 225 Smith Ave N, Suite 200, Saint Paul, MN 55102
Phone: 651-241-6550    Fax: 651-241-6586
Dr. Diane S Ogren, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 310 Smith Ave N, Saint Paul, MN 55102
Phone: 952-843-4333    Fax: 952-843-4301
Dr. Robert Elliott Bulander Jr., M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 640 Jackson St, Mail Stop 11502v, Saint Paul, MN 55101
Phone: 651-254-3136    Fax: 651-254-1480
Dean E Mann, MD
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 640 Jackson St, Mc 11503b, Saint Paul, MN 55101
Phone: 651-254-3792    Fax: 651-254-8208

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.