Samuel Gray Deem, DO
Individual provider Active NPI Urology Physician · Charleston, WV
NPI 1700909702 · NPPES record last updated Dec 1, 2025
Key facts
- NPI
- 1700909702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 2176 (WV)
- Practice address
- 3100 Maccorkle Ave SE
Suite 602
Charleston, WV 25304-1223 - Phone
- (304) 388-5120
- Fax
- (304) 388-5125
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Urology
- Education
- West Virginia School of Osteopathic Medicine, 2004
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Charleston Area Medical Center Inc
Camc Greenbrier Valley Medical Center Inc
Practice addresses (Care Compare)
1220 Lee St E
Charleston, WV 25301-1863
Phone (304) 388-7270
1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 343-4371
1521 Maplewood Ave
Ronceverte, WV 24970-8026
Phone (304) 647-5642
3100 Maccorkle Ave SE
Suite 610
Charleston, WV 25304-1231
Phone (304) 388-5280
400 Association Dr
Suite 102
Charleston, WV 25311-1298
501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432
Hospital & facility affiliations
- Charleston Area Medical Center
- Camc Greenbrier Valley Medical Center, Inc
- Camc Charleston Surgical Hospital
- Boone Memorial Hospital
- Logan Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.94 of 100
- Quality
- 69.71
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 21 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071113000323 | WV | Practitioner - Urology |
2860580610 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2176 | WV | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camc Greenbrier Valley Medical Center Inc | Urology | Current |
Accepting new patients |
| Charleston Area Medical Center Inc | Current |
Accepting new patients | |
| Charleston Area Medical Center, Inc. | Current | Accepting new patients | |
| Monongalia County General Hospital Company | Current |
Accepting new patients | |
| Camc Greenbrier Valley Medical Center, Inc. | Current |
Accepting new patients | |
| Charleston Area Medical Center, Inc. | Past | Accepting new patients | |
| Charleston Area Medical Center Inc | Past | Accepting new patients | |
| Charleston Area Medical Center Inc | Past | Accepting new patients | |
| Greenbrier VMC LLC | Past | Accepting new patients |
Locations
3100 Maccorkle Ave SE
Ste 602
Charleston, WV 25304
Phone (304) 388-5120
501 Morris St
Charleston, WV 25301
Phone (304) 348-6293
400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762
415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290
3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273
1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460
1521 Maplewood Ave
Ronceverte, WV 24970
1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 2176 | WV | Yes |
Addresses
Primary practice location
3100 Maccorkle Ave SE
Suite 602
Charleston, WV 25304-1223
Mailing address
3100 Maccorkle Ave SE Ste 602
Charleston, WV 25304-1231
Phone (304) 388-5280
Other practice location 1
1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01087428 | Other | WV | RAILROAD MEDICARE |
| 3810010649 | Medicaid | WV |
Other providers in Charleston, WV
- Jessica Jean Dearman
- Denia Debord
- Sheri Debord
- Debra L. Parsons PLLC
- Anthony J Decarlo Jr.
- Timothy Ray Deer
- Kelly Dees
- Kory Dees
- Chealse Deese
- Kiley Rose Defibaugh
All providers in Charleston, WV · Urology Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.