Individual provider Active NPI

Samuel C Lee, DO

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1770508376
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K0107 Issued in TX
Practice address
2223 NE 28TH St
Fort Worth, TX 76106-7418
Phone
(817) 624-3211
Fax
(817) 625-9835
NPI assigned
Jul 13, 2006
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K0107 TX Primary

Addresses

Primary practice location

2223 NE 28TH St
Fort Worth, TX 76106-7418

Mailing address

2223 NE 28TH St
Fort Worth, TX 76106-7418
Phone (817) 624-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20101012001296 TX Practitioner - Family Practice 7012903495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

2223 NE 28TH St
Wellmed at Diamond Hill
Fort Worth, TX 76106-7418
Phone (817) 624-3211

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Family Medicine CurrentSince Apr 10, 2023 Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Apr 10, 2023 Accepting new patients
Medical Clinic of North Texas PLLC PastSince Dec 24, 2023 Accepting new patients

Locations

1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818

2223 NE 28th St
Ft Worth, TX 76106
Phone (817) 624-3211

800 8th Ave
Ste 528
Ft Worth, TX 76104
Phone (817) 336-5633

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: samuel.lee@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1770508376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 NE 28TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761067418",
            "telephone_number": "817-624-3211",
            "fax_number": "817-625-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 NE 28TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761067418",
            "telephone_number": "817-624-3211",
            "fax_number": "817-625-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SAMUEL",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.