Dr Samuel Jay Peretsman, MD - Medicare Urology in Charlotte, NC

Dr Samuel Jay Peretsman, MD is a medicare enrolled "Urology" physician in Charlotte, North Carolina. He went to Boston University School Of Medicine and graduated in 1983 and has 41 years of diverse experience with area of expertise as Urology. He is a member of the group practice Deaconess Clinic Inc, Prisma Health Medical Group-midlands and his current practice location is 201 Queens Rd, Charlotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at (704) 372-5180.

Dr Samuel Jay Peretsman is licensed to practice in North Carolina (license number 9500688) 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 1912946336.

Contact Information

Dr Samuel Jay Peretsman, MD
201 Queens Rd,
Charlotte, NC 28204-3217
(704) 372-5180
(704) 376-6280



Physician's Profile

Full NameDr Samuel Jay Peretsman
GenderMale
SpecialityUrology
Experience41 Years
Location201 Queens Rd, Charlotte, North Carolina
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:
  • Dr Samuel Jay Peretsman attended and graduated from Boston University School Of Medicine in 1983
  NPI Data:
  • NPI Number: 1912946336
  • Provider Enumeration Date: 06/05/2006
  • Last Update Date: 05/30/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5092749093
  • Enrollment ID: I20230615000428

Medical Identifiers

Medical identifiers for Dr Samuel Jay Peretsman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912946336NPI-NPPES
10465OtherNCPARTNERS PROVIDER #
66833OtherNCBCBS INDI PROVIDER #
340016821OtherNCRAILROAD MEDICARE INDI #

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology 89031 (South Carolina)Secondary
208800000XUrology 9500688 (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Deaconess Hospital IncEvansville, INHospital
Prisma Health BaptistColumbia, SCHospital
Prisma Health Richland HospitalColumbia, SCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Deaconess Clinic Inc3375610116337
Prisma Health Medical Group-midlands5991099707865

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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. Dr Samuel Jay Peretsman allows following entities to bill medicare on his behalf.
Entity NameDeaconess Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619123585
PECOS PAC ID: 3375610116
Enrollment ID: O20080922000145

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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. Dr Samuel Jay Peretsman 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
Dr Samuel Jay Peretsman, MD
Po Box 36488,
Charlotte, NC 28236-6488

Ph: (704) 248-3400
Dr Samuel Jay Peretsman, MD
201 Queens Rd,
Charlotte, NC 28204-3217

Ph: (704) 372-5180

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Urology Doctors in Charlotte, NC

Mark J. Makhuli, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1225 Harding Pl, Ste 3100, Charlotte, NC 28204
Phone: 704-355-8686    
Dr. George Albert Dasher, M.D.
Urology
Medicare: Not Enrolled in Medicare
Practice Location: 10512 Park Rd, Suite 113, Charlotte, NC 28210
Phone: 704-541-8207    
Dr. Craig H Robson, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 335 N Caswell Rd, Charlotte, NC 28204
Phone: 704-384-7980    
Peter Earl Clark, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1021 Morehead Medical Dr, Ste 6100, Charlotte, NC 28204
Phone: 980-442-2000    
Jonathan Pierce Walker, MD
Urology
Medicare: Medicare Enrolled
Practice Location: 1001 Blythe Blvd, Charlotte, NC 28203
Phone: 704-446-5070    
E Matthew Dilizia, MD
Urology
Medicare: Medicare Enrolled
Practice Location: 10660 Park Rd Ste 4100, Charlotte, NC 28210
Phone: 704-541-8207    Fax: 704-540-8288
Dr. Lawrence Andrew Eskew, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 335 N Caswell Rd, Charlotte, NC 28204
Phone: 704-384-7980    Fax: 704-384-7985

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