Samantha Ellen Pederson, PA-C in Lincoln, NE - Medicare Physician Assistant

Samantha Ellen Pederson, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Lincoln, Nebraska. Her current practice location is 5200 S 56th St Ste 2, Lincoln, Nebraska. You can reach out to her office (for appointments etc.) via phone at (402) 421-6200.

Samantha Ellen Pederson is licensed to practice in Nebraska (license number 2565) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033885504.

Contact Information

	Samantha Ellen Pederson, PA-C
	5200 S 56th St Ste 2, Lincoln, NE 68516-1891
	(402) 421-6200
	(402) 421-6070

Physician's Profile

Full Name	Samantha Ellen Pederson
Gender	Female
Speciality	Physician Assistant - Medical
Location	5200 S 56th St Ste 2, Lincoln, Nebraska
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033885504
Provider Enumeration Date: 08/17/2021
Last Update Date: 09/01/2022

Medicare PECOS Information:

PECOS PAC ID: 9133525934
Enrollment ID: I20210902000662

Medical Identifiers

Medical identifiers for Samantha Ellen Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033885504	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	2565 (Nebraska)	Secondary
363AM0700X	Physician Assistant - Medical	2565 (Nebraska)	Primary

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. Samantha Ellen Pederson 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
Samantha Ellen Pederson, PA-C 5200 S 56th St Ste 2, Lincoln, NE 68516-1891 Ph: (402) 421-6200	Samantha Ellen Pederson, PA-C 5200 S 56th St Ste 2, Lincoln, NE 68516-1891 Ph: (402) 421-6200

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Samantha Ellen Pederson, PA-C - Medicare Physician Assistant in Lincoln, NE