SAMUEL B RENNEBOHM PHD
NPI 1790238814
Psychologist - Clinical in Seattle, WA
About Samuel B Rennebohm Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL B RENNEBOHM PHD (NPI 1790238814) is an individual clinical provider in Seattle, Washington, licensed in Washington (PY61016748) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted 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 B Rennebohm Phd 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
SEATTLE, WA 98104
SEATTLE, WA 98104
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 Rennebohm's NPI number?
The NPI number for Samuel Rennebohm is 1790238814. It was assigned to this individual provider in the NPPES registry on July 25, 2016.
Where is Samuel Rennebohm located?
Samuel Rennebohm practices at 1401 Madison St Ste 100, Seattle, WA 98104. The listed phone number is (206) 386-6111.
What is Samuel Rennebohm's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Samuel Rennebohm enrolled in Medicare?
Yes. Samuel Rennebohm 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 Rennebohm accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Samuel Rennebohm 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 Rennebohm was last updated on September 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 B Rennebohm, PHD · NPI 1790238814
Clinical provider in Seattle, Washington. Individual provider, active in the CMS NPPES registry since July 25, 2016.
## Identity
- **NPI:** 1790238814 (Entity type: Individual)
- **Enumerated:** July 25, 2016
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PY61016748 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 1401 MADISON ST STE 100, Seattle, WA 98104-1316
- **Phone:** (206) 386-6111 · **Fax:** (206) 386-6111
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** September 30, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1790238814) · Data from the CMS NPPES public registry.