SETH LERNER MD
NPI 1669552063
Urology in Houston, TX

Q: What is Seth Lerner's NPI number?

The NPI number for Seth Lerner is 1669552063. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Q: What is Seth Lerner's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Seth Lerner was last updated on November 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 October 17, 2006PECOS EnrolledAccepts Medicare Assignment

91.34/100

CMS Quality Rating

6560 FANNIN ST, HOUSTON, TX 77030(713) 798-4001(713) 798-6005 Get Directions Write a Review

NPPES record last updated: November 20, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Seth Lerner Md NPPES

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

SETH LERNER MD (NPI 1669552063) is an individual urology provider in Houston, Texas, licensed in Texas (G8900) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Chi St Luke's Health Baylor College Of Medicine Me, and is a graduate of Baylor College Of Medicine (1984).

NPPES Registry Identity

NPI1669552063

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameSETH LERNERCredential: MD

Location Address6560 FANNIN STHouston, TX 77030-2761

Mailing Address6560 Fannin StHouston, TX 77030-2761 · (713) 798-4001 · Fax (713) 798-6005

Phone(713) 798-4001

Fax(713) 798-6005

Sole ProprietorNo

Medical School CMSBaylor College Of MedicineGraduated 1984

Enumeration DateOctober 17, 2006

Last NPPES UpdateNovember 20, 2020

NPPES CertifiedNovember 20, 2020

✔ NPI 1669552063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in TX · G8900

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

6560 FANNIN ST, Houston, TX 77030

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Other Identifiers 1

Medicaid123401502TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Blue Cross and Blue Shield of Texas and more.Insurance ›

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

Seth Lerner Md 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 ID9931199320

PECOS Enrollment IDI20040517001052

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 14

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

127 services90 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

119 services88 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

114 services67 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

100 services74 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

64 services46 patients

Biopsy of bladder using an endoscope 52204

A biopsy of the bladder using an endoscope is a procedure where a small sample of bladder tissue is collected for testing. An endoscope, a flexible tube with a light and camera, is used to see inside the bladder. This helps to identify any abnormal areas. The procedure helps in the diagnosis of various conditions.

33 services30 patients

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.

25 services21 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

23 services23 patients

Limited ultrasound scan behind abdominal cavity 76775

A limited ultrasound scan behind the abdominal cavity is a non-invasive imaging method that helps visualize structures in the back of your abdomen. This procedure uses sound waves to create pictures of these areas, assisting in diagnosing certain conditions.

19 services19 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

17 services16 patients

Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm 52235

This procedure involves using a thin, flexible tool called an endoscope to examine and remove a growth in your bladder and urethra. The growth size ranges from 2.0-5.0 cm. This is done to ensure your urinary system functions properly.

14 services13 patients

Removal of bladder neck through urethra 52500

This procedure involves accessing the bladder through a natural opening in your body. The goal is to remove a part of the bladder called the 'bladder neck' that may be causing issues. It's typically done under anesthesia and is a common, safe procedure.

14 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

14 services14 patients

Destruction and/or removal of large growth of bladder using an endoscope 52240

This procedure involves using a special instrument, an endoscope, to view and treat a large growth in the bladder. The growth is either destroyed or removed to alleviate symptoms and prevent further complications. It's a minimally invasive technique, enhancing recovery.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chi St Luke's Health Baylor College Of Medicine Me

Acute Care Hospitals · Houston, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450193

Location6720 Bertner Ave, Ste Mc1-266Houston, TX 77030 · Harris County

Emergency services

St Luke's The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450862

Location17200 St Luke's WayThe Woodlands, TX 77384 · Montgomery County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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

$134.06 typical visit price

range $58.24 – $176.98

Typical copayment $33.51 (range $14.56 – $44.24)

Most-billed visit code 99204

Established Patient

$72.62 typical visit price

range $18.60 – $143.93

Typical copayment $18.15 (range $4.65 – $35.98)

Most-billed visit code 99213

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

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.

91.34/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.64

Promoting Interoperability

89.13

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Irrigation syringe, bulb or piston, each A4322

DME-Medical/Surgical Supplies · category DA000N

1 supplier12 claims144 services$2.73 avg. paid by Medicare

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

2 suppliers33 claims9,590 services$0.11 avg. paid by Medicare

Male external catheter, with or without adhesive, disposable, each A4349

DME-Medical/Surgical Supplies · category DA000N

3 suppliers15 claims828 services$1.66 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

3 suppliers67 claims10,740 services$1.69 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

1 supplier51 claims11,120 services$6.13 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

7 suppliers55 claims208 services$7.42 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 L ATTISHA RN, ACNP

Nurse Practitioner

6560 FANNIN ST, STE 1260
HOUSTON, TX 77030

Harris County (713) 797-0466

TIEN WONG M.D.

Ophthalmology

6560 FANNIN ST, STE 750
HOUSTON, TX 77030

Harris County (713) 524-3434

DR. OLGA WALN M.D.

Psychiatry & Neurology (Neurology)

6560 FANNIN ST, STE 802
HOUSTON, TX 77030

Harris County (713) 441-9551

PARTNERS IN INTERNAL MEDICINE, P.A.

Internal Medicine

6560 FANNIN ST, SUITE 1012
HOUSTON, TX 77030

Harris County (281) 657-0770

KEVIN ANTHONY GRIMES MD

Internal Medicine (Infectious Disease)

6560 FANNIN ST, SUITE 1540
HOUSTON, TX 77030

Harris County (713) 799-9997

NICOLE BAUTISTA DAVENPORT P.A.-C

Physician Assistant

6560 FANNIN ST, SUITE 1842
HOUSTON, TX 77030

Harris County (713) 790-2089

DR. MICHAEL POOL COSELLI M.D.

Surgery

6560 FANNIN ST, STE 1608
HOUSTON, TX 77030

Harris County (713) 796-1608

DR. WILLIAM HYPES OBENOUR JR. M.D.

Internal Medicine

6560 FANNIN ST, SUITE 1112
HOUSTON, TX 77030

Harris County (713) 790-1541

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 Seth Lerner's NPI number?

The NPI number for Seth Lerner is 1669552063. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Where is Seth Lerner located?

Seth Lerner practices at 6560 Fannin St, Houston, TX 77030. The listed phone number is (713) 798-4001.

What is Seth Lerner's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Seth Lerner enrolled in Medicare?

Yes. Seth Lerner 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.

What insurance does Seth Lerner accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Blue Cross and Blue Shield of Texas, Community Health Choice and Molina Healthcare and 2 other insurers list Seth Lerner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Seth Lerner affiliated with any hospitals?

According to CMS data, Seth Lerner is affiliated with Chi St Luke's Health Baylor College Of Medicine Me and St Luke's The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Seth Lerner was last updated on November 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.