Jeffrey Sam, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.168925 Issued in IL

Practice address

14268 Lacey Dr
Lemont, IL 60439-8549

Phone

(630) 414-9335

NPI assigned

Apr 19, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Internal Medicine

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• St Joseph Memorial Hospital Nursing home, CCN 14Z334

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as group

Quality

77.5

Improvement activities

40

Cost

74.58

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsam79543@sih.direct-ci.com

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

• 24 On Physicians, PC

  • Hospitalist Physician
  • Ottawa, IL
  • NPI 1346480431
  Medicare reassignment Care Compare group NPD
• Broadmed LLC

  • General Acute Care Hospital
  • Lemont, IL
  • NPI 1083453849
  NPD Authorized official
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD
• Holland Community Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1780888099
  NPD

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

• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • Critical Access Hospital
  • Murphysboro, IL
  • NPI 1356435135
  Care Compare affiliation
• Southern Illinois Hospital Services

  • Medicare Defined Swing Bed Hospital Unit
  • Murphysboro, IL
  • NPI 1639595036

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1912588138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14268 LACEY DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398549",
            "telephone_number": "630-414-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14268 LACEY DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398549",
            "telephone_number": "630-414-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.168925",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royal Bee Transport LLC
• Francis Ruane
• Neha Saeed
• Ahmet Sakiri, MD
• Gabrielle Salazar
• Phyllis Louise Samplawski, MSW
• Ana M Sanchez
• Karl Sarceno, LPT
• Michele Marie Schmidt, RN D.O.N
• Diane M Schroeder, PHARMBS

• Internal Medicine Physician in Lemont, IL
• Providers in Lemont, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.