Ms Samala Jackson, CRNP in Berwyn, PA - Medicare Nurse Practitioner

Ms Samala Jackson, CRNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Berwyn, Pennsylvania. She graduated from nursing school in 2017 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Vpa Pc, Osh - Pa Physicians Group, Pc and her current practice location is 1055 Westlakes Dr Ste 3152, Berwyn, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (215) 346-6050.

Ms Samala Jackson is licensed to practice in Pennsylvania (license number SP018935) 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 1184362600.

Contact Information

	Ms Samala Jackson, CRNP
	1055 Westlakes Dr Ste 3152, Berwyn, PA 19312-2410
	(215) 346-6050
	(215) 220-3562

Map and Direction

Provider's Profile

Full Name	Ms Samala Jackson
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	1055 Westlakes Dr Ste 3152, Berwyn, Pennsylvania
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ms Samala Jackson graduated from nursing school in 2017

NPI Data:

NPI Number: 1184362600
Provider Enumeration Date: 05/24/2022
Last Update Date: 10/24/2025

Medicare PECOS Information:

PECOS PAC ID: 6800277153
Enrollment ID: I20220718001252

Medical Identifiers

Medical identifiers for Ms Samala Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184362600	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	SP018935 (Pennsylvania)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mercy Home Health	Springfield, PA	Home health agency
Bayada Home Health Care, Inc.	Jamison, PA	Home health agency
Southeastern Home Health Services	Bristol, PA	Home health agency
Bayada Home Health Care, Inc.	Philadelphia, PA	Home health agency
Holy Redeemer Home Care-pa	Philadelphia, PA	Home health agency

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Vpa Pc	9234041948	179
Osh - Pa Physicians Group, Pc	7517213879	121

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. Ms Samala Jackson allows following entities to bill medicare on her behalf.

Entity Name	Primary Homecare Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629023593 PECOS PAC ID: 3274437462 Enrollment ID: O20031120000241

Entity Name	Osh - Pa Physicians Group, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811405533 PECOS PAC ID: 7517213879 Enrollment ID: O20180629000414

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. Ms Samala Jackson 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
Ms Samala Jackson, CRNP Po Box 40412, Belfast, ME 04915-1255 Ph: (248) 824-6500	Ms Samala Jackson, CRNP 1055 Westlakes Dr Ste 3152, Berwyn, PA 19312-2410 Ph: (215) 346-6050

Reviews and Comments

Nurse Practitioner Nurses in Berwyn, PA

Mary Evans Greene, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 685 Kromer Ave, Berwyn, PA 19312 Phone: 109-950-1006 Fax: 109-950-4006
Kaelen Mcmullin, AGPCNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1001 Chesterbrook Blvd, Berwyn, PA 19312 Phone: 570-640-7262 Fax: 610-576-7707
Kathryn Emily Walters, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1001 Chesterbrook Blvd Fl 3, Berwyn, PA 19312 Phone: 610-576-7500 Fax: 215-576-7708
Mrs. Margareth Fontaine, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2010 Buttonwood Rd, Berwyn, PA 19312 Phone: 484-319-2288
Mrs. Jennifer Grubb, CRNP, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1055 Westlakes Dr Fl 3, Berwyn, PA 19312 Phone: 610-298-5800 Fax: 610-968-1676
Patricia A Gillin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1001 Chesterbrook Blvd Fl 2, Berwyn, PA 19312 Phone: 610-576-7500

Ms Samala Jackson, CRNP - Medicare Nurse Practitioner in Berwyn, PA