Active NPI
Samuel S Lee, MD
- Anesthesiology Physician
- Ashtabula, OH
National Provider Identifier
1871588053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 35036540L
- Practice address
- 2420 Lake Ave
Ashtabula, OH 44004-4954 - Phone
- (440) 997-2262
- NPI assigned
- Sep 14, 2005
- Last updated
- Sep 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 35036540L | OH | Primary |
Addresses
Primary practice location
2420 Lake Ave
Ashtabula, OH 44004-4954
Mailing address
PO Box 74751
Cleveland, OH 44194-0834
Phone (440) 997-2262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0448153 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35036540L | OH | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443398400000",
"number": "1871588053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 74751",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441940834",
"telephone_number": "440-997-2262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2420 LAKE AVE",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440044954",
"telephone_number": "440-997-2262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SAMUEL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2015-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OH",
"license": "35036540L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0448153",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.