Samuel Shin Kwon Lee, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A49819 Issued in CA

Practice address

18400 US Highway 18
Apple Valley, CA 92307-2306

Phone

(760) 242-3939

Fax

(760) 242-3232

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Urology

Education

Tulane University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Desert Valley Medical Group IncGroup PAC ID 4880595875, 78 clinicians

Palm Valley Multi-Specialty Medical Group PCGroup PAC ID 8628412418, 17 clinicians

Urologic Institute of the High Desert IncGroup PAC ID 3476681008, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300
• Victor Valley Global Medical Center Hospital, Victorville, CA, CCN 050517
• Barstow Community Hospital Hospital, Barstow, CA, CCN 050298
• Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333

Merit-based Incentive Payment System (MIPS)

Final score

94.79 of 100Reported as group

Quality

84.63

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: slee190261@santaclaravalley.direct-ci.net
• Direct secure messaging: samuel.lee.p1@direct.dvmg.nextgenshare.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.

• Desert Valley Medical Group, Inc.

  • Physical Therapist
  • Victorville, CA
  • NPI 1639117864
  Medicare reassignment Care Compare group NPD
• Palm Valley Multi-Specialty Medical Group PC

  • Urology Physician
  • Apple Valley, CA
  • NPI 1770344186
  Medicare reassignment Care Compare group NPD
• Urologic Institute of the High Desert Inc.

  • Urology Physician
  • Apple Valley, CA
  • NPI 1376867333
  Medicare reassignment Care Compare group NPD
• Halo Medical Group

  dba Desert Medical Imaging

  • Diagnostic Radiology Physician
  • Indian Wells, CA
  • NPI 1467506451

  Urology

  Medicare reassignment NPD
• New Hope Urology, LLC

  • Specialist
  • Duluth, GA
  • NPI 1922062280
  NPD (past) Authorized official
• Desert Valley Medical Group, Inc

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1952020315
  NPD
• Desert Valley Medical Group, Inc.

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1801848452

  Urology

  NPD
• Halo Medical Group

  dba Chico Breast Care Center II, INC.

  • Diagnostic Radiology Physician
  • Chico, CA
  • NPI 1154950236
  NPD
• Desert Valley Hospital, LLC

  dba Desert Valley Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  NPD (past)
• Dignity Health

  dba St. Mary Medical Center

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)
• HMG Urology PC

  • Family Medicine Physician
  • Indian Wells, CA
  • NPI 1770210684

  Urology

  NPD (past)
• Hospital of Barstow Inc

  dba Barstow Community Hospital

  • General Acute Care Hospital
  • Barstow, CA
  • NPI 1780655670
  NPD (past)

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

• Desert Valley Hospital, LLC

  dba Desert Valley Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  Care Compare affiliation
• Hospital of Barstow Inc

  dba Barstow Community Hospital

  • General Acute Care Hospital
  • Barstow, CA
  • NPI 1780655670
  Care Compare affiliation
• Ridgecrest Regional Hospital

  • Critical Access Hospital
  • Ridgecrest, CA
  • NPI 1447253125
  Care Compare affiliation
• Ridgecrest Regional Hospital

  • Land Ambulance
  • Ridgecrest, CA
  • NPI 1699398560

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  Care Compare affiliation
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186
  Care Compare affiliation
• Victor Valley Hospital Acquisition, Inc.

  dba Victor Valley Global Medical Center

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1679879589
  Care Compare affiliation

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1194772418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18400 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072306",
            "telephone_number": "760-242-3939",
            "fax_number": "760-242-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18400 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072306",
            "telephone_number": "760-242-3939",
            "fax_number": "760-242-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SAMUEL",
        "middle_name": "SHIN KWON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "110101",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "060213",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A49819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "785000022",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Lee, O.D.
• Jaehoon Lee, O.D.
• Jeong Lee
• Jerrica Laifun Lee, PHARMD
• Kyung H Lee, L.AC
• Seung Hee Lee
• Stormie Lee
• Legacy Therapeutic Services, Inc. (The Children's Clinic)
• Dulce Virginia Leguizamo, MSW
• Desiree T. Lelless

• Urology Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.