DR. SAMUAL KELLY LAVIS DO
NPI 1508429093
Family Medicine in Arlington, WA

Q: What is Samual Lavis's NPI number?

The NPI number for Samual Lavis is 1508429093. It was assigned to this individual provider in the NPPES registry on April 19, 2019.

Q: What is Samual Lavis's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: Is Samual Lavis enrolled in Medicare?

No. Samual Lavis has opted out of Medicare through August 15, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Samual Lavis was last updated on November 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 19, 2019Opted out of Medicare · through Aug 15, 2027

3823 172ND ST NE, ARLINGTON, WA 98223(360) 657-8700(360) 657-8717 Get Directions Write a Review

NPPES record last updated: November 16, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 16, 2022, Aug 3, 2022, Apr 19, 2019 (3 updates tracked since 2019).

On this page

About Dr. Samual Kelly Lavis Do NPPES

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

DR. SAMUAL KELLY LAVIS DO (NPI 1508429093) is an individual family medicine provider in Arlington, Washington, licensed in Washington (OP61122427) and active in the NPI registry since April 2019. He has opted out of Medicare through August 15, 2027 and remains eligible to order and refer and maintains a secondary practice location in Mount Vernon.

NPPES Registry Identity

NPI1508429093

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SAMUAL KELLY LAVISCredential: DO

Location Address3823 172ND ST NEArlington, WA 98223-7735

Mailing Address1400 E Kincaid StMount Vernon, WA 98274-4127

Phone(360) 657-8700

Fax(360) 657-8717

Sole ProprietorNo

Enumeration DateApril 19, 2019

Last NPPES UpdateNovember 16, 20223 updates tracked since enumeration

NPPES CertifiedNovember 16, 2022

✔ NPI 1508429093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · OP61122427

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3823 172ND ST NE, Arlington, WA 98223

Open in Google Maps ↗

Secondary Practice Location 1

Location 12320 Freeway DrMount Vernon, WA 98273-5445 · Phone (360) 814-6850 · Fax (360) 814-6920

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Samual Kelly Lavis Do has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 15, 2023 through August 15, 2027.

Opt-Out Effective DateAugust 15, 2023

Opt-Out In Effect ThroughAugust 15, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KAREN S IN

Social Worker (Clinical)