LIONEL MARSHALL NELSON MD
NPI 1902838063
Otolaryngology in San Jose, CA

Q: What is Lionel Nelson's NPI number?

The NPI number for Lionel Nelson is 1902838063. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Q: What is Lionel Nelson's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Lionel Nelson was last updated on February 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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 July 07, 2006PECOS EnrolledAccepts Medicare Assignment

87.26/100

CMS Quality Rating

2577 SAMARITAN DR STE 765, SAN JOSE, CA 95124(408) 358-6163(408) 358-2302 Get Directions Write a Review

NPPES record last updated: February 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 28, 2025, Mar 30, 2016 (2 updates tracked since 2016).

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About Lionel Marshall Nelson Md NPPES

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

LIONEL MARSHALL NELSON MD (NPI 1902838063) is an individual otolaryngology provider in San Jose, California, licensed in California (G19842) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Jose, and is a graduate of Yale University School Of Medicine (1969).

NPPES Registry Identity

NPI1902838063

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameLIONEL MARSHALL NELSONCredential: MD

Location Address2577 SAMARITAN DR STE 765San Jose, CA 95124-4109

Mailing Address2577 Samaritan Dr Ste 765San Jose, CA 95124-4109 · (408) 358-6163 · Fax (408) 358-2302

Phone(408) 358-6163

Fax(408) 358-2302

Sole ProprietorNo

Medical School CMSYale University School Of MedicineGraduated 1969

Enumeration DateJuly 7, 2006

Last NPPES UpdateFebruary 28, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2025

✔ NPI 1902838063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in CA · G19842

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

2577 SAMARITAN DR STE 765, San Jose, CA 95124

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Secondary Practice Location 1

Location 12505 Samaritan Dr #510San Jose, CA 95124 · Phone (408) 358-6163 · Fax (408) 358-2302

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

Lionel Marshall Nelson 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 ID7810185402

PECOS Enrollment IDI20101227000110

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 7

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 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.

163 services122 patients

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.

152 services117 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.

90 services90 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

70 services65 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

59 services57 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.

51 services51 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95124 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

$156.67 typical visit price

range $70.37 – $206.04

Typical copayment $39.16 (range $17.59 – $51.51)

Most-billed visit code 99204

Established Patient

$86.56 typical visit price

range $23.96 – $169.60

Typical copayment $21.64 (range $5.99 – $42.40)

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.

87.26/100

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

Scored through an Alternative Payment Model

Quality

82.97

Promoting Interoperability

85.91

Improvement Activities

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)

96%46 patients4/55-star benchmark: 100%

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

0%103 patients

Breast Cancer Screening

24%303 patients2/55-star benchmark: 93%

Cervical Cancer Screening

16%340 patients1/55-star benchmark: 98%

Colorectal Cancer Screening

13%643 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

41%111 patients2/55-star benchmark: 91%

Diabetes: Eye Exam

14%29 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

66%29 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

97%1,936 patients4/55-star benchmark: 100%

e-Prescribing

98%150 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

4%543 patients1/55-star benchmark: 100%

HIV Screening

12%749 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

45%1,240 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

2%1,215 patients1/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 90% · 460 patients

88%460 patients

Provide Patients Electronic Access to Their Health Information

97%344 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

75%129 patients3/55-star benchmark: 91%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 7

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

DR. HUSSEIN AMIRALI SAMJI M.D.

Otolaryngology