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JENNIFER SAM
NPI 1336405059
Nurse Practitioner - Psychiatric/Mental Health in Shelby Township, MI

Active since April 06, 2012PECOS Enrolled
13045 MICHAEL DR, SHELBY TOWNSHIP, MI 48315(248) 225-1959 Get Directions Write a Review

NPPES record last updated: May 9, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 9, 2024, Apr 12, 2022, Sep 27, 2021 and 1 more (4 updates tracked since 2021).

About Jennifer Sam NPPES

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

JENNIFER SAM (NPI 1336405059) is an individual psychiatric/mental health provider in Shelby Township, Michigan, licensed in Michigan (4704248128) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Rochester.

NPPES Registry Identity

NPI1336405059
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJENNIFER SAM
Location Address13045 MICHAEL DRShelby Township, MI 48315-4744
Mailing Address13045 Michael DrShelby Township, MI 48315-3952 · (248) 225-1959
Phone(248) 225-1959
Sole ProprietorYes
Enumeration DateApril 6, 2012
Last NPPES UpdateMay 9, 20244 updates tracked since enumeration
NPPES CertifiedMay 9, 2024
✔ NPI 1336405059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MI · 4704248128
Also ListedNurse PractitionerTaxonomy 363L00000X · License 4704248128 (MI)
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 4704248128 (MI)
13045 MICHAEL DR, Shelby Township, MI 48315
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Secondary Practice Location 1

Location 1210 W University Dr Ste 6DRochester, MI 48307-1975 · Phone (586) 330-0659

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Sam 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 Reassignments

5

Medicare enrollment records show Jennifer Sam reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Henry Ford Macomb Hospital Corporation
2.7 mi
Neonatal
15855 19 MILE RD
Clinton Township, MI 48038
  • Reassigned Medicare billing, Michigan enrollment
  • 215 clinicians in this Medicare group
NPI 1912301094 (586) 263-2300
Henry Ford Health Eastwood Behavioral Health
5.4 mi
Social Worker
37500 GARFIELD RD STE 175
Clinton Township, MI 48036
  • Reassigned Medicare billing, Michigan enrollment
  • 98 clinicians in this Medicare group
NPI 1396787701 (586) 792-5335
Henry Ford Health Macomb Oakland Hospital
9.5 mi
Nurse Practitioner
11800 E 12 MILE RD
Warren, MI 48093
  • Reassigned Medicare billing, Michigan enrollment
  • 58 clinicians in this Medicare group
NPI 1578696092 (586) 573-5000
Arman C. Moshyedi, MD, PLLC
26 mi
Psychiatry
31590 SCHOOLCRAFT RD
Livonia, MI 48150
  • Reassigned Medicare billing, Michigan enrollment
  • 17 clinicians in this Medicare group
NPI 1700440203 (855) 940-4867
Core Psych PLLC
28 mi
Psychiatry
3815 PELHAM ST
Dearborn, MI 48124
  • Reassigned Medicare billing, Michigan enrollment
  • 9 clinicians in this Medicare group
NPI 1871069039 (313) 429-0470

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 48315 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

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 Jennifer Sam's NPI number?

The NPI number for Jennifer Sam is 1336405059. It was assigned to this individual provider in the NPPES registry on April 6, 2012.

Where is Jennifer Sam located?

Jennifer Sam practices at 13045 Michael Dr, Shelby Township, MI 48315. The listed phone number is (248) 225-1959.

What is Jennifer Sam's specialty?

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

Is Jennifer Sam enrolled in Medicare?

Yes. Jennifer Sam is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jennifer Sam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Sam reassigns Medicare benefits to 5 organizations: Henry Ford Macomb Hospital Corporation (Clinton Township, MI), Henry Ford Health Eastwood Behavioral Health (Clinton Township, MI), Henry Ford Health Macomb Oakland Hospital (Warren, MI), Arman C. Moshyedi, MD, PLLC (Livonia, MI) and Core Psych PLLC (Dearborn, MI). Each 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 Jennifer Sam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Sam accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Jennifer Sam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Sam was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.