Samuel B Pegram, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

F9937 Issued in TX

Practice address

3316 Williams Dr Ste 150
Georgetown, TX 78628-2891

Phone

(512) 244-4272

Fax

(512) 244-2895

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Rheumatology

Education

Ohio State University College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Seton Medical Center Harker Heights Hospital, Harker Heights, TX, CCN 670080
• Adventhealth Central Texas Hospital, Killeen, TX, CCN 450152
• Adventhealth Rollins Brook Hospital, Lampasas, TX, CCN 451323

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.pegram.1@24201.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark Malone MD PA

  • Pain Medicine (Anesthesiology) Physician
  • Round Rock, TX
  • NPI 1407057250
  Medicare reassignment Care Compare group NPD
• Mark Malone, MD PA

  • Pain Medicine (Anesthesiology) Physician
  • Killeen, TX
  • NPI 1982581427
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HH Killeen Health System LLC

  • General Acute Care Hospital
  • Harker Heights, TX
  • NPI 1841562709
  Care Compare affiliation
• Metroplex Adventist Hospital Inc

  • General Acute Care Hospital
  • Killeen, TX
  • NPI 1629089966
  Care Compare affiliation
• Metroplex Adventist Hospital Inc

  • Critical Access Hospital
  • Lampasas, TX
  • NPI 1750392916
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1528043130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 WILLIAMS DR STE 150",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282891",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 S Mays St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786647580",
            "country_code": "US",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEGRAM",
        "first_name": "SAMUEL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "F9937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128203006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pearl Family Practice PA
• Devin Peck, M.D.
• Pediatric Associates of Georgetown, PA
• Kelly Pedrozo, CD
• Peds Center of Round Rock PA
• Jacobo Pena, M.D.
• Jessica Michelle Pena, PTA
• Samantha Pena, LMFT
• Xin Peng
• Marla B Pennell, AUD CCC-A

• Rheumatology Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Rheumatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.