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DR. PRINCE D SAMUEL MD
NPI 1295730299
Ophthalmology - Retina Specialist in Evansville, IN

Active since June 16, 2005PECOS Enrolled
4221 WASHINGTON AVE, EVANSVILLE, IN 47714(812) 476-6500(812) 476-6507 Get Directions Write a Review

NPPES record last updated: April 24, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Prince D Samuel Md NPPES

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

DR. PRINCE D SAMUEL MD (NPI 1295730299) is an individual retina specialist in Evansville, Indiana, licensed in Indiana (01057972A) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295730299
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameDR. PRINCE D SAMUELCredential: MD
Location Address4221 WASHINGTON AVEEvansville, IN 47714-0675
Mailing Address4221 Washington AveEvansville, IN 47714-0675 · (812) 476-6500 · Fax (812) 476-6507
Phone(812) 476-6500
Fax(812) 476-6507
Sole ProprietorYes
Enumeration DateJune 16, 2005
Last NPPES UpdateApril 24, 2017
✔ NPI 1295730299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in IN · 01057972A
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
4221 WASHINGTON AVE, Evansville, IN 47714
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINH72575IN
Medicare PIN208850AIN
Medicaid200454280IN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Prince D Samuel Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Prince Samuel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hayden Vision LLC
0.5 mi
Ophthalmology
3801 BELLEMEADE AVE
Evansville, IN 47714
  • Reassigned Medicare billing, Indiana enrollment
  • 4 clinicians in this Medicare group
NPI 1982910253 (812) 477-3937

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47714 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%179 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

DR. ERIC JOHN MOREAU O.D.
Optometrist
4221 WASHINGTON AVE
EVANSVILLE, IN 47714
Vanderburgh County (812) 474-0006
VITREO RETINAL CENTER PC
Ophthalmology
4221 WASHINGTON AVE
EVANSVILLE, IN 47714
Vanderburgh County (812) 476-6500

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 Prince Samuel's NPI number?

The NPI number for Prince Samuel is 1295730299. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Prince Samuel located?

Prince Samuel practices at 4221 Washington Ave, Evansville, IN 47714. The listed phone number is (812) 476-6500.

What is Prince Samuel's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Prince Samuel enrolled in Medicare?

Yes. Prince Samuel is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Prince Samuel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prince Samuel reassigns Medicare benefits to Hayden Vision LLC (Evansville, IN). 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 Prince Samuel'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 Prince Samuel was last updated on April 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.