SAMUEL EDUSA MD
NPI 1710664198
Student in an Organized Health Care Education/Training Program in Athens, GA

Q: What is Samuel Edusa's NPI number?

The NPI number for Samuel Edusa is 1710664198. It was assigned to this individual provider in the NPPES registry on June 28, 2023.

Q: What is Samuel Edusa's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samuel Edusa was last updated on June 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 28, 2023PECOS Enrolled

1270 PRINCE AVE STE 102, ATHENS, GA 30606(706) 475-7055 Get Directions Write a Review

NPPES record last updated: June 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Samuel Edusa Md NPPES

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

SAMUEL EDUSA MD (NPI 1710664198) is an individual student in an organized health care education/training program in Athens, Georgia and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710664198

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL EDUSACredential: MD

Location Address1270 PRINCE AVE STE 102Athens, GA 30606-2700

Mailing Address1270 Prince Ave Ste 102Athens, GA 30606-2700

Phone(706) 475-7055

Sole ProprietorNo

Enumeration DateJune 28, 2023

NPPES CertifiedJune 28, 2023

✔ NPI 1710664198 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.

1270 PRINCE AVE STE 102, Athens, GA 30606

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Edusa 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.