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SAMUEL GAGNE
NPI 1508397753
Student in an Organized Health Care Education/Training Program in Bronx, NY

Active since March 21, 2017PECOS Enrolled
111 E 210TH ST, BRONX, NY 10467(718) 741-2460(718) 654-6692 Get Directions Write a Review

NPPES record last updated: March 21, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Samuel Gagne NPPES

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

SAMUEL GAGNE (NPI 1508397753) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508397753
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL GAGNE
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address111 E 210th StBronx, NY 10467-2401 · (718) 741-2460 · Fax (718) 654-6692
Phone(718) 741-2460
Fax(718) 654-6692
Sole ProprietorNo
Enumeration DateMarch 21, 2017
✔ NPI 1508397753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
111 E 210TH ST, Bronx, NY 10467
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Gagne 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

2

Medicare enrollment records show Samuel Gagne reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pinnacle Health Medical Services
133 mi
Family Medicine
4229 OREGON PIKE
Ephrata, PA 17522
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,902 clinicians in this Medicare group
NPI 1043978125 (717) 445-4371
University Of Pittsburgh Physicians
311 mi
Urgent Care
464 ALLEGHENY BLVD, PENNWOOD CENTER
Franklin, PA 16323
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7,114 clinicians in this Medicare group
NPI 1619381456 (814) 432-9801

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

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.

HEATHER ROOT MD
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-8592
MICHAEL GOTTESMAN M.D.
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-5506
JIAE LEE M.D.
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
DR. MICHELLE DOMINIQUE PINTEA MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
TELISHA MCLEAN
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
SHIVADITYA CHOUDHURY
Anesthesiology
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
MS. JOHANNA SHEA-FEN TAN
Student in an Organized Health Care Education/Training Program
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
JACK DANIEL HALLIGAN MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321

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 Gagne's NPI number?

The NPI number for Samuel Gagne is 1508397753. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Where is Samuel Gagne located?

Samuel Gagne practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 741-2460.

What is Samuel Gagne's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samuel Gagne enrolled in Medicare?

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

Which organizations bill Medicare for Samuel Gagne's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Gagne reassigns Medicare benefits to 2 organizations: Pinnacle Health Medical Services (Ephrata, PA) and University Of Pittsburgh Physicians (Franklin, PA). 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 Samuel Gagne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Gagne accept?

Health plans from CareSource list Samuel Gagne 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 Samuel Gagne was last updated on March 21, 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.