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LYSA SAMUEL PA
NPI 1174737423
Physician Assistant - Medical in Oakland, CA

Active since May 09, 2007PECOS EnrolledAccepts Medicare Assignment
91.04/100
CMS Quality Rating
3100 TELEGRAPH AVE, #2109 EAST BAY FAMILY PRACTICE MEDICAL GROUP INC, OAKLAND, CA 94609(510) 645-9900(510) 645-9919 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lysa Samuel Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYSA SAMUEL PA (NPI 1174737423) is an individual medical provider in Oakland, California, licensed in (PA16296) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1174737423
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameLYSA SAMUELCredential: PA
Location Address3100 TELEGRAPH AVE, #2109 EAST BAY FAMILY PRACTICE MEDICAL GROUP INCOakland, CA 94609
Mailing Address3100 Telegraph Ave, #2109 East Bay Family Practice Medical Group IncOakland, CA 94609 · (510) 645-9900 · Fax (510) 645-9919
Phone(510) 645-9900
Fax(510) 645-9919
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateMay 9, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174737423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed · PA16296
3100 TELEGRAPH AVE, Oakland, CA 94609
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lysa Samuel Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224079892
PECOS Enrollment IDI20050513000709
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
108 services71 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.13
Promoting Interoperability100
Improvement Activities40
Cost64.1

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JANET ARNESTY MD
Family Medicine
3100 TELEGRAPH AVE, #2109
OAKLAND, CA 94609
Alameda County (510) 645-9900
DR. MARTHA A. TRACY M.D.
Internal Medicine (Hematology & Oncology)
3100 TELEGRAPH AVE, SUITE 3101
OAKLAND, CA 94609
Alameda County (510) 834-6923
DR. JOHN CHAMBERS GOOD MD
Family Medicine
3100 TELEGRAPH AVE, SUITE 2102
OAKLAND, CA 94609
Alameda County (810) 286-8160
SARA BUCKELEW MD
Pediatrics
3100 TELEGRAPH AVE, 2ND FLOOR
OAKLAND, CA 94609
Alameda County (510) 452-5231
Q. ROBERT YAN, M.D. PROFESSIONAL CORPORATION
Urology
3100 TELEGRAPH AVE, SUITE 3000
OAKLAND, CA 94609
Alameda County (510) 238-1238
STEVEN T YEDLIN M.D.
Surgery (Pediatric Surgery)
3100 TELEGRAPH AVE, 2ND FLOOR BAYSIDE MEDICAL GROUP
OAKLAND, CA 94609
Alameda County (510) 452-5231
DR. ANGLYN SASSER PSY.D.
Psychologist
3100 TELEGRAPH AVE, #303
OAKLAND, CA 94609
Alameda County (619) 459-6097
DR. TOM KUO LEE M. D.
Internal Medicine (Hematology & Oncology)
3100 TELEGRAPH AVE, SUITE 3106
OAKLAND, CA 94609
Alameda County (510) 271-7999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lysa Samuel's NPI number?

The NPI number for Lysa Samuel is 1174737423. It was assigned to this individual provider in the NPPES registry on May 9, 2007.

Where is Lysa Samuel located?

Lysa Samuel practices at 3100 Telegraph Ave #2109 East Bay Family Practice Medical Group Inc, Oakland, CA 94609. The listed phone number is (510) 645-9900.

What is Lysa Samuel's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Lysa Samuel enrolled in Medicare?

Yes. Lysa Samuel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Lysa Samuel was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.