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DR. SAMUEL PENNELLA JR. MD
NPI 1124524038
General Practice in Detroit, MI

Active since April 02, 2018PECOS EnrolledAccepts Medicare Assignment
607 SHELBY ST STE 700, DETROIT, MI 48226(908) 208-8926 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 6, 2026, Mar 27, 2026, Mar 15, 2026 and 3 more (6 updates tracked since 2020).

About Dr. Samuel Pennella Jr. Md NPPES

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

DR. SAMUEL PENNELLA JR. MD (NPI 1124524038) is an individual general practice provider in Detroit, Michigan, licensed in Michigan (4301510893) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lebanon, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1124524038
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. SAMUEL PENNELLA JR.Credential: MD
Location Address607 SHELBY ST STE 700Detroit, MI 48226-3282
Mailing Address14 Glennon Farm LnLebanon, NJ 08833-4504 · (908) 208-8926
Phone(908) 208-8926
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateApril 2, 2018
Last NPPES UpdateMay 6, 20266 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1124524038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in MI · 4301510893✔ Licensed in MN · 68449✔ Licensed in KS · TW00059✔ Licensed in FL · TPME2986✔ Licensed in CO · DR.0074417
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
607 SHELBY ST STE 700, Detroit, MI 48226
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Secondary Practice Location 1

Location 114 Glennon Farm LnLebanon, NJ 08833-4504 · Phone (908) 208-8926

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Samuel Pennella Jr. 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 ID8123427267
PECOS Enrollment IDI20260310001780
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.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Pennella reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pennella Integrated Health PLLC
Same address
General Practice
607 SHELBY ST STE 700
Detroit, MI 48226
  • Reassigned Medicare billing, Michigan enrollment
NPI 1508702333 (908) 208-8926

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
419 services412 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
112 services110 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
94 services94 patients

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise L0637
DME-Orthotic Devices · category DF007N
4 suppliers25 claims25 services$955.83 avg. paid by Medicare
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0650
DME-Orthotic Devices · category DF007N
12 suppliers55 claims55 services$777.39 avg. paid by Medicare
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf L1833
DME-Orthotic Devices · category DF011N
7 suppliers24 claims38 services$422.47 avg. paid by Medicare
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise L1843
DME-Orthotic Devices · category DF011N
3 suppliers15 claims26 services$741.25 avg. paid by Medicare
Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf L1851
DME-Orthotic Devices · category DF011N
5 suppliers31 claims55 services$608.41 avg. paid by Medicare
Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment L1971
DME-Orthotic Devices · category DF003N
3 suppliers15 claims29 services$387.23 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

PENNELLA INTEGRATED HEALTH PLLC
General Practice
607 SHELBY ST STE 700
DETROIT, MI 48226
Wayne County (908) 208-8926
COMFORTING HEARTS COUNSELING SOLUTIONS,LLC
Social Worker (Clinical)
607 SHELBY ST STE 700
DETROIT, MI 48226
Wayne County (313) 799-9251

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 Samuel Pennella's NPI number?

The NPI number for Samuel Pennella is 1124524038. It was assigned to this individual provider in the NPPES registry on April 2, 2018.

Where is Samuel Pennella located?

Samuel Pennella practices at 607 Shelby St Ste 700, Detroit, MI 48226. The listed phone number is (908) 208-8926.

What is Samuel Pennella's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Samuel Pennella enrolled in Medicare?

Yes. Samuel Pennella 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.

Which organization bills Medicare for Samuel Pennella's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Pennella reassigns Medicare benefits to Pennella Integrated Health PLLC (Detroit, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Pennella's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samuel Pennella was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.