Mrs Carla Samantha Vasquez, FNP - Medicare Nurse Practitioner in Yadkinville, NC

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.

Contact Information

Mrs Carla Samantha Vasquez, FNP
305 E Lee Ave,
Yadkinville, NC 27055-8132
(336) 679-2661
(336) 679-7056



Physician's Profile

Full NameMrs Carla Samantha Vasquez
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location305 E Lee Ave, Yadkinville, North Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  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.
IdentifierTypeStateIssuer
1225674088NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2083P0500XPreventive Medicine - Preventive Medicine/occupational Environmental Medicine 247085 (North Carolina)Secondary
363L00000XNurse Practitioner 5012577 (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Novant Health Forsyth Medical CenterWinston-salem, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Forsyth Memorial Hospital Inc9537071790531

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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. Mrs Carla Samantha Vasquez allows following entities to bill medicare on her behalf.
Entity NameNovant Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366409492
PECOS PAC ID: 1153234893
Enrollment ID: O20031121000692

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Entity NameForsyth Memorial Hospital Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice Location Address
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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