Mrs Carla Samantha Vasquez, FNP is a medicare enrolled "Nurse Practitioner" physician in Yadkinville, North Carolina. She graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Forsyth Memorial Hospital Inc and her current practice location is
305 E Lee Ave, Yadkinville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 679-2661.
Mrs Carla Samantha Vasquez is licensed to practice in North Carolina (license number 5012577) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225674088.
Physician's Profile
| Full Name | Mrs Carla Samantha Vasquez |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 305 E Lee Ave, Yadkinville, North Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Carla Samantha Vasquez graduated from medical school in 2019
NPI Data:
- NPI Number: 1225674088
- Provider Enumeration Date: 11/26/2019
- Last Update Date: 10/26/2020
Medicare PECOS Information:
- PECOS PAC ID: 2668808916
- Enrollment ID: I20200204001869
Medical Identifiers
Medical identifiers for Mrs Carla Samantha Vasquez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225674088 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | 247085 (North Carolina) | Secondary |
| 363L00000X | Nurse Practitioner | 5012577 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Forsyth Memorial Hospital Inc | 9537071790 | 531 |
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. Mrs Carla Samantha Vasquez allows following entities to bill medicare on her behalf.
| Entity Name | Novant Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366409492
PECOS PAC ID: 1153234893
Enrollment ID: O20031121000692 |
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| Entity Name | Forsyth Memorial Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104548874
PECOS PAC ID: 9537071790
Enrollment ID: O20040405001702 |
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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. Mrs Carla Samantha Vasquez 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 |
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Mrs Carla Samantha Vasquez, FNP
Po Box 751803,
Charlotte, NC 28275-1803
Ph: () - | Mrs Carla Samantha Vasquez, FNP
305 E Lee Ave,
Yadkinville, NC 27055-8132
Ph: (336) 679-2661 |
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