Individual provider Active NPI

Samantha Gillian Lee, CPNP

  • Pediatric Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1548435134
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4932 Issued in CT
Practice address
282 Washington St
Division of Hospital Medicine
Hartford, CT 06106-3322
Phone
(860) 545-8236
NPI assigned
Apr 24, 2008
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F3819431 NY
Pediatric Nurse Practitioner 363LP0200X 4932 CT Primary

Addresses

Primary practice location

282 Washington St
Division of Hospital Medicine
Hartford, CT 06106-3322

Mailing address

282 Washington St
Division of Hospital Medicine
Hartford, CT 06106-3322
Phone (860) 545-8236

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slee7415@connecticutchildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140702002170 CT Practitioner - Nurse Practitioner 4981829033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4932CTMDPediatric Nurse Practitioner
F3819431NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Medical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1548435134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "address_2": "DIVISION OF HOSPITAL MEDICINE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "address_2": "DIVISION OF HOSPITAL MEDICINE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SAMANTHA",
        "middle_name": "GILLIAN",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F3819431",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "4932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slee7415@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "address_2": "Division of Hospital Medicine",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.