Samuel C Lee, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95031946 Issued in CA

Practice address

9011 Princeton Way
Buena Park, CA 90620-4639

Phone

(661) 886-9954

NPI assigned

Nov 6, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1326861386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 PRINCETON WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204639",
            "telephone_number": "661-886-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 PRINCETON WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204639",
            "telephone_number": "661-886-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SAMUEL",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyungmi Lee
• Luke Joo Lee, PH,D
• Moonyoung Milton Lee, D.C.
• Nari Lee
• Phillip Lee, DPT
• Sang DO Lee, DC
• Sherlynn Ji Hyun Lee, PA-C
• Soledad O Lee, MD
• Sooji Hong Lee, D.D.S.
• Sujin Lee

• Family Nurse Practitioner in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.