SAMUEL DOCKERY DO
NPI 1386104917
Emergency Medicine in Kettering, OH
About Samuel Dockery Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL DOCKERY DO (NPI 1386104917) is an individual emergency medicine provider in Kettering, Ohio, licensed in Ohio (34.015695) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Fairview Hospital, and is a graduate of Touro Un Col Of Osteopathic Medicine, New York (2019).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
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
Samuel Dockery Do 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.
Medicare Billing Reassignment
Medicare enrollment records show Samuel Dockery reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Avon, OH 44011
- Reassigned Medicare billing, Ohio enrollment
- 7,608 clinicians in this Medicare group
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 5
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Fairview Hospital
Acute Care Hospitals · Cleveland, OHCleveland Clinic
Acute Care Hospitals · Cleveland, OHCleveland Clinic Avon Hospital
Acute Care Hospitals · Avon, OHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45429 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Dockery's NPI number?
The NPI number for Samuel Dockery is 1386104917. It was assigned to this individual provider in the NPPES registry on March 20, 2019.
Where is Samuel Dockery located?
Samuel Dockery practices at 3525 Southern Blvd, Kettering, OH 45429. The listed phone number is (937) 395-8839.
What is Samuel Dockery's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Samuel Dockery enrolled in Medicare?
Yes. Samuel Dockery 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 Dockery's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Dockery reassigns Medicare benefits to The Cleveland Clinic Foundation (Avon, OH). 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 Dockery's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samuel Dockery accept?
Health plans from CareSource list Samuel Dockery 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.
Is Samuel Dockery affiliated with any hospitals?
According to CMS data, Samuel Dockery is affiliated with Fairview Hospital, Cleveland Clinic and Cleveland Clinic Avon Hospital.
When was this NPI record last updated?
The NPPES record for Samuel Dockery was last updated on July 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Samuel Dockery, DO · NPI 1386104917
Emergency Medicine physician in Kettering, Ohio. Individual provider, active in the CMS NPPES registry since March 20, 2019.
## Identity
- **NPI:** 1386104917 (Entity type: Individual)
- **Enumerated:** March 20, 2019
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 34.015695 (Ohio)
- **Sole proprietor:** No
## Practice location
- **Address:** 3525 SOUTHERN BLVD, Kettering, OH 45429-1221
- **Phone:** (937) 395-8839 · **Fax:** (937) 395-8387
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** The Cleveland Clinic Foundation (NPI 1184428336, Avon, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Touro Un Col Of Osteopathic Medicine, New York, class of 2019
## Record status
- **NPPES last updated:** July 7, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1386104917) · Data from the CMS NPPES public registry.