Individual provider Active NPI

Albert D Sam II, MD

  • Vascular Surgery Physician
  • Chicago, IL
National Provider Identifier
1396736971
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036.096155 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(312) 355-4300
NPI assigned
Nov 2, 2005
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036.096155 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

840 S. Wood Street 376-CSN
(M/C 958)
Chicago, IL 60612
Phone (312) 996-8459

Other practice location 1

1801 W Taylor St # 3F
Chicago, IL 60612-4795
Phone (312) 355-4300

Other identifiers 1

IdentifierTypeStateIssuer
1162604MedicaidLA

Other names 1

  • Albert Devon Sam Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200309000277 DC Practitioner - Vascular Surgery 3971495151 Reassigns benefits to 2 organizations
I20200507002014 VA Practitioner - Vascular Surgery 3971495151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Duke University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

1600 N Beauregard St
Alexandria, VA 22311-1732
Phone (571) 472-0080

2501 Parkers LN
Alexandria, VA 22306-3209

3300 Gallows Rd
Falls Church, VA 22042-3307

3580 Joseph Siewick Dr
Fairfax, VA 22033-1764

4320 Seminary Rd
Alexandria, VA 22304-1535

44045 Rivderside Pkwy
Leesburg, VA 20176-5101

8081 Innovation Park Dr
Fairfax, VA 22031-4867

8140 Ashton Ave
Manassas, VA 20109-5700
Phone (703) 280-5858

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal15
Leg revascularization (restoring blood flow)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15157RLAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vascular Medicine LLC Single Specialty CurrentSince Oct 15, 2020 Accepting new patients
Inova Health Care Services Single Specialty CurrentSince Feb 10, 2020 Accepting new patients
Inova Health Care Services Single Specialty CurrentSince Feb 10, 2020 Accepting new patients
Inova Health Care Services Single Specialty CurrentSince Feb 10, 2020 Accepting new patients
Center for Vascular Medicine NJ, LLC Single Specialty Past Accepting new patients
Our Lady of the Lake Physician Group LLC Single Specialty Past Accepting new patients

Locations

7300 Hanover Dr
Ste 104
Greenbelt, MD 20770
Phone (301) 982-2000

7500 Greenway Center Dr
Ste 201
Greenbelt, MD 20770

1600 N Beauregard St
Ste 150
Alexandria, VA 22311
Phone (571) 472-0080

1800 N Beauregard St
Ste 50
Alexandria, VA 22311
Phone (703) 205-7330

8316 Arlington Blvd
Ste 515
Fairfax, VA 22031
Phone 3019822000999

2921 Telestar Ct
Ste 140
Falls Church, VA 22042
Phone (703) 280-1473

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

501 Park Hill Dr
Ste 104
Fredericksburg, VA 22401

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8140 Ashton Ave
Ste 125
Manassas, VA 20109
Phone (571) 665-6550

8200 Greensboro Dr
Ste 210
McLean, VA 22102
Phone (703) 506-8346

14605 Potomac Branch Dr
Ste 210
Woodbridge, VA 22191
Phone (703) 205-7330

Interoperability endpoints

  • Direct secure messaging: asam682568@soc.inova.org
  • Direct secure messaging: edson.pineda.p4@direct.cvm-usa.nextgenshare.com

Organizations & group practices 6

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

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1396736971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S. WOOD STREET 376-CSN",
            "address_2": "(M/C 958)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-8459",
            "fax_number": "312-355-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-355-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Taylor St # 3F",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-355-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "ALBERT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036.096155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1162604",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALBERT",
            "last_name": "SAM",
            "middle_name": "DEVON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.