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SAMSON MICHAEL JOLLY MD
NPI 1023758984
Internal Medicine in Worcester, MA

Active since March 30, 2022PECOS EnrolledAccepts Medicare Assignment
119 BELMONT ST, WORCESTER, MA 01605(508) 334-8515(508) 334-6490 Get Directions Write a Review

NPPES record last updated: April 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Samson Michael Jolly Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMSON MICHAEL JOLLY MD (NPI 1023758984) is an individual internal medicine provider in Worcester, Massachusetts, licensed in Massachusetts (1021919) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Medical Center/university Campus, and maintains a secondary practice location in Worcester.

NPPES Registry Identity

NPI1023758984
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSAMSON MICHAEL JOLLYCredential: MD
Location Address119 BELMONT STWorcester, MA 01605-2903
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977
Phone(508) 334-8515
Fax(508) 334-6490
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2022
Enumeration DateMarch 30, 2022
Last NPPES UpdateApril 14, 2025
NPPES CertifiedApril 14, 2025
✔ NPI 1023758984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MA · 1021919
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
119 BELMONT ST, Worcester, MA 01605
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Secondary Practice Location 1

Location 155 Lake Ave NWorcester, MA 01655-0002 · Phone (508) 334-8515 ext. 50833

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samson Michael Jolly Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365828308
PECOS Enrollment IDI20250418001307
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PANKAJ ANIL KSHEERSAGAR M.B.B.S.,M.D
Family Medicine
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-5571
JASON D YANG
Internal Medicine (Rheumatology)
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-5224
SANDRA BELLINI N.P.
Nurse Practitioner (Neonatal, Critical Care)
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-6470
BENJAMIN D. HAMAR MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-0550
WALTER J ZAWACKI NP
Nurse Practitioner
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-8934
CARYN SULLIVAN LCSW
Social Worker
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-1000
WAYNE WAYFU CHAN M.D.
Orthopaedic Surgery
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-9750
NICHOLAS PAICOS PA STUDENT
Physician Assistant
119 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-8515

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samson Jolly's NPI number?

The NPI number for Samson Jolly is 1023758984. It was assigned to this individual provider in the NPPES registry on March 30, 2022.

Where is Samson Jolly located?

Samson Jolly practices at 119 Belmont St, Worcester, MA 01605. The listed phone number is (508) 334-8515.

What is Samson Jolly's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Samson Jolly enrolled in Medicare?

Yes. Samson Jolly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Samson Jolly affiliated with any hospitals?

According to CMS data, Samson Jolly is affiliated with Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Samson Jolly was last updated on April 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.