Richard Leslie Sample, MD in Montgomery, AL

Richard Leslie Sample, MD is a medicare enrolled "Family Medicine" physician in Montgomery, Alabama. His current practice location is 4371 Narrow Lane Rd, Montgomery, Alabama. You can reach out to his office (for appointments etc.) via phone at (334) 613-3680.

Richard Leslie Sample is licensed to practice in Alabama (license number DO898) 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 1497713200.

Contact Information

	Richard Leslie Sample, MD
	4371 Narrow Lane Rd, Montgomery, AL 36116-2971
	(334) 613-3680
	(334) 613-3685

Map and Direction

Physician's Profile

Full Name	Richard Leslie Sample
Gender	Male
Speciality	Family Medicine
Location	4371 Narrow Lane Rd, Montgomery, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1497713200
Provider Enumeration Date: 05/02/2006
Last Update Date: 03/27/2008

Medicare PECOS Information:

PECOS PAC ID: 5193754943
Enrollment ID: I20050811000585

Medical Identifiers

Medical identifiers for Richard Leslie Sample such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497713200	NPI	-	NPPES
009937494	Medicaid	AL
0403254	Other	AL	UNITED HEALTHCARE
630813275	Other	AL	COMMERCIAL
051557580	Other	AL	MEDICARE PROVIDER #
051542076	Other	AL	BCBS PROVIDER #

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	DO898 (Alabama)	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. Richard Leslie Sample allows following entities to bill medicare on his behalf.

Entity Name	Jackson Hospital And Clinic, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073264107 PECOS PAC ID: 0547254153 Enrollment ID: O20040414000971

Entity Name	Ivy Creek Of Elmore Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558868323 PECOS PAC ID: 8426075508 Enrollment ID: O20051027001031

Entity Name	Nes Tennessee, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437606605 PECOS PAC ID: 3678472040 Enrollment ID: O20161031002328

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. Richard Leslie Sample 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
Richard Leslie Sample, MD 4371 Narrow Lane Rd, Montgomery, AL 36116-2975 Ph: (334) 613-3680	Richard Leslie Sample, MD 4371 Narrow Lane Rd, Montgomery, AL 36116-2971 Ph: (334) 613-3680

Reviews and Comments

Family Medicine Doctors in Montgomery, AL

Thavatchai Chamnongchareonwong, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8300 Crossland Loop, Montgomery, AL 36117 Phone: 334-239-8939 Fax: 334-239-8918
Dr. Mohammad Irfan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 440 Taylor Rd, Suite 3380, Montgomery, AL 36117 Phone: 334-213-6287 Fax: 334-213-6288
Claire Casey, NP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 Taylor Rd, Montgomery, AL 36117 Phone: 334-747-8448
Mr. Mihir M Pradhan, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 2105 E South Blvd, Baptist Medical Center South, Montgomery, AL 36116 Phone: 334-286-2987 Fax: 334-286-3368
Dr. Belfondia Pou, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2031 Normandie Dr, Montgomery, AL 36111 Phone: 334-284-6755 Fax: 334-284-6756
Nandini Yashwanti Ramroop, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 2055 E South Blvd, Suite 308, Montgomery, AL 36116 Phone: 334-286-2390 Fax: 334-286-2397
Trupti Nadkar, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4371 Narrow Lane Rd Ste 100, Montgomery, AL 36116 Phone: 334-747-3680 Fax: 334-747-7880

Richard Leslie Sample, MD - Medicare Family Medicine in Montgomery, AL