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SAMUEL T. JERSAK MD
NPI 1497141014
Hospitalist in Columbus, OH

Active since April 09, 2015PECOS EnrolledAccepts Medicare Assignment
82.34/100
CMS Quality Rating
410 W 10TH AVE, COLUMBUS, OH 43210(614) 293-7499(614) 366-2360 Get Directions Write a Review

NPPES record last updated: June 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 29, 2021, Jul 2, 2018 (2 updates tracked since 2018).

About Samuel T. Jersak Md NPPES

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

SAMUEL T. JERSAK MD (NPI 1497141014) is an individual hospitalist provider in Columbus, Ohio, licensed in Ohio (35.132780) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Saint Luke's South Hospital, and is a graduate of University Of Missouri, Columbia School Of Medicine (2015).

NPPES Registry Identity

NPI1497141014
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameSAMUEL T. JERSAKCredential: MD
Location Address410 W 10TH AVEColumbus, OH 43210
Mailing Address901 E 104th StKansas City, MO 64131-4517 · (816) 502-8752 · Fax (816) 932-9670
Phone(614) 293-7499
Fax(614) 366-2360
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 2015
Enumeration DateApril 9, 2015
Last NPPES UpdateJune 29, 20212 updates tracked since enumeration
NPPES CertifiedJune 29, 2021
✔ NPI 1497141014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in OH · 35.132780
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
410 W 10TH AVE, Columbus, OH 43210
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas City, Blue Cross and Blue Shield of Kansas, Inc., Medica.Insurance ›

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

Samuel T. Jersak 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 ID648589176
PECOS Enrollment IDI20210630003741, I20210819001190
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.

Areas of Expertise CMS Part B claims 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
192 services83 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
170 services76 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
71 services71 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
48 services48 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
40 services39 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
33 services33 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Luke's South Hospital

Acute Care Hospitals · Overland Park, KS
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number170185
Location12300 Metcalf AvenueOverland Park, KS 66213 · Johnson County
Emergency services

St Lukes Hospital Of Kansas City

Acute Care Hospitals · Kansas City, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260138
Location4401 Wornall RoadKansas City, MO 64111 · Jackson County
Emergency services Birthing friendly

Golden Valley Memorial Hospital

Acute Care Hospitals · Clinton, MO
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number260175
Location1600 N 2nd StClinton, MO 64735 · Henry County
Emergency services Birthing friendly

Wright Memorial Hospital

Critical Access Hospitals · Trenton, MO
OwnershipVoluntary non-profit - Private
CMS Certification Number261309
Location191 Iowa BoulevardTrenton, MO 64683 · Grundy County
Emergency services

Hedrick Medical Center

Critical Access Hospitals · Chillicothe, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number261321
Location2799 North Washington StreetChillicothe, MO 64601 · Livingston County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43210 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

82.34/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality94.94
Improvement Activities0
Cost79.7

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers17 claims17 services$15.32 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers17 claims17 services$69.32 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 20

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

LARA L. VANHUYSEN C.R.N.A.
Nurse Anesthetist, Certified Registered
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8487
LAUREN TALANDA-FATH SOUTHERLAND M.D.
Emergency Medicine
410 W 10TH AVE, EMERGENCY DEPARTMENT
COLUMBUS, OH 43210
Franklin County (614) 293-8305
RAFAL KOPANCZYK DO
Anesthesiology
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8487
RACHEL MARIE ASHWORTH CRNA
Nurse Anesthetist, Certified Registered
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8487
ADAM T. RAMEY MD
Hospitalist
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-7499
DR. AMY ELIZABETH SCHULTZ PHARM.D.
Pharmacist
410 W 10TH AVE, 368 DOAN HALL
COLUMBUS, OH 43210
Franklin County (614) 366-6754
MAYA HARARY MD
Neurological Surgery
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-8714
NICOLE L HESS APRN-CNP
Nurse Practitioner
410 W 10TH AVE
COLUMBUS, OH 43210
Franklin County (614) 293-9600

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 Jersak's NPI number?

The NPI number for Samuel Jersak is 1497141014. It was assigned to this individual provider in the NPPES registry on April 9, 2015.

Where is Samuel Jersak located?

Samuel Jersak practices at 410 W 10th Ave, Columbus, OH 43210. The listed phone number is (614) 293-7499.

What is Samuel Jersak's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Samuel Jersak enrolled in Medicare?

Yes. Samuel Jersak 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.

What insurance does Samuel Jersak accept?

Health plans from Blue Cross and Blue Shield of Kansas City, Blue Cross and Blue Shield of Kansas, Inc. and Medica list Samuel Jersak 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 Jersak affiliated with any hospitals?

According to CMS data, Samuel Jersak is affiliated with Saint Luke's South Hospital, St Lukes Hospital Of Kansas City, Golden Valley Memorial Hospital, Wright Memorial Hospital and Hedrick Medical Center.

When was this NPI record last updated?

The NPPES record for Samuel Jersak was last updated on June 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.