SAMUELLE A JEAN CHARLES
NPI 1174365118
Nurse Practitioner - Psychiatric/Mental Health in Somerville, MA

Q: What is Samuelle Jean Charles's NPI number?

The NPI number for Samuelle Jean Charles is 1174365118. It was assigned to this individual provider in the NPPES registry on June 11, 2024.

Q: What is Samuelle Jean Charles's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since June 11, 2024PECOS EnrolledAccepts Medicare Assignment

645 BROADWAY, SOMERVILLE, MA 02145(781) 712-6141 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2025, Jun 11, 2024 (2 updates tracked since 2024).

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About Samuelle A Jean Charles NPPES

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

SAMUELLE A JEAN CHARLES (NPI 1174365118) is an individual psychiatric/mental health provider in Somerville, Massachusetts, licensed in Massachusetts (RN2291984) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Malden, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1174365118

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSAMUELLE A JEAN CHARLES

Location Address645 BROADWAYSomerville, MA 02145-2528

Mailing Address147 Clifton St Unit 2Malden, MA 02148-2526 · (857) 389-4086

Phone(781) 712-6141

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateJune 11, 2024

Last NPPES UpdateMay 8, 20252 updates tracked since enumeration

NPPES CertifiedMay 8, 2025

✔ NPI 1174365118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in MA · RN2291984

645 BROADWAY, Somerville, MA 02145

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Secondary Practice Location 1

Location 1147 Clifton St Unit 2Malden, MA 02148-2526 · Phone (857) 389-4086

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

Samuelle A Jean Charles 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 ID1052848363

PECOS Enrollment IDI20241227002002

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02145 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

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.

ISABELLA HOPE TAYLOR

Student in an Organized Health Care Education/Training Program