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JEFFREY SAMELSON PHD
NPI 1801866223
Psychologist - Clinical in Michigan City, IN

Active since January 26, 2006PECOS EnrolledAccepts Medicare Assignment
104 WOODLAND CT STE B, MICHIGAN CITY, IN 46360(219) 628-6463(219) 628-6463 Get Directions Write a Review

NPPES record last updated: March 7, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jeffrey Samelson Phd NPPES

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

JEFFREY SAMELSON PHD (NPI 1801866223) is an individual clinical provider in Michigan City, Indiana, licensed in Indiana (20010303A) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1977).

NPPES Registry Identity

NPI1801866223
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameJEFFREY SAMELSONCredential: PHD
Location Address104 WOODLAND CT STE BMichigan City, IN 46360-7391
Mailing Address1225 E Coolspring AveMichigan City, IN 46360-6312 · (219) 873-2964 · Fax (219) 873-2933
Phone(219) 628-6463
Fax(219) 628-6463
Sole ProprietorNo
Medical School CMSOtherGraduated 1977
Enumeration DateJanuary 26, 2006
Last NPPES UpdateMarch 7, 2024
NPPES CertifiedMarch 7, 2024
✔ NPI 1801866223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IN · 20010303A
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologistTaxonomy 103T00000X · License 20010303A (IN)
104 WOODLAND CT STE B, Michigan City, IN 46360
Open in Google Maps ↗

Other Identifiers 3

Medicaid100162900IN
OtherP00616032Rr Medicare
Other000000347073IN · Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Jeffrey Samelson 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.

PECOS PAC ID1759354251
PECOS Enrollment IDI20040813000494
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 Reassignment

Medicare enrollment records show Jeffrey Samelson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sacks Clinical Consulting, PC
Same address
Counseling
107 WOODLAND CT, STE B
Michigan City, IN 46360
  • Reassigned Medicare billing, Indiana enrollment
  • 2 clinicians in this Medicare group
NPI 1548567241 (219) 628-6463

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

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.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
61 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46360 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
$161.76 typical visit price
range $53.07 – $161.76
Typical copayment $40.44 (range $13.26 – $40.44)
Most-billed visit code 99205
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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 Jeffrey Samelson's NPI number?

The NPI number for Jeffrey Samelson is 1801866223. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Where is Jeffrey Samelson located?

Jeffrey Samelson practices at 104 Woodland Ct Ste B, Michigan City, IN 46360. The listed phone number is (219) 628-6463.

What is Jeffrey Samelson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeffrey Samelson enrolled in Medicare?

Yes. Jeffrey Samelson 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 Jeffrey Samelson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Samelson reassigns Medicare benefits to Sacks Clinical Consulting, PC (Michigan City, IN). 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 Jeffrey Samelson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffrey Samelson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Cigna Healthcare list Jeffrey Samelson 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 Jeffrey Samelson was last updated on March 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.