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DR. JEFFREY SAM DO
NPI 1912588138
Internal Medicine in Lemont, IL

Active since April 19, 2021PECOS EnrolledAccepts Medicare Assignment
14268 LACEY DR, LEMONT, IL 60439(630) 414-9335 Get Directions Write a Review

NPPES record last updated: August 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 6, 2024, Jun 6, 2021, Apr 19, 2021 (3 updates tracked since 2021).

About Dr. Jeffrey Sam Do NPPES

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

DR. JEFFREY SAM DO (NPI 1912588138) is an individual internal medicine provider in Lemont, Illinois, licensed in Illinois (036.168925) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and is a graduate of Lincoln Mem Univ, Debusk Col Of Osteopathic Med (2020).

NPPES Registry Identity

NPI1912588138
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JEFFREY SAMCredential: DO
Location Address14268 LACEY DRLemont, IL 60439-8549
Mailing Address14268 Lacey DrLemont, IL 60439-8549 · (630) 414-9335
Phone(630) 414-9335
Sole ProprietorYes
Medical School CMSLincoln Mem Univ, Debusk Col Of Osteopathic MedGraduated 2020
Enumeration DateApril 19, 2021
Last NPPES UpdateAugust 6, 20243 updates tracked since enumeration
NPPES CertifiedAugust 6, 2024
✔ NPI 1912588138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036.168925
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
14268 LACEY DR, Lemont, IL 60439
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jeffrey Sam Do 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 ID7315349735
PECOS Enrollment IDI20241104001699
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.

Medicare Billing Reassignment

Medicare enrollment records show Jeffrey Sam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

24 On Physicians, PC
50 mi
Hospitalist
1100 E NORRIS DR
Ottawa, IL 61350
  • Reassigned Medicare billing, Illinois enrollment
  • 233 clinicians in this Medicare group
NPI 1346480431 (800) 923-2247

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
31 services15 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
20 services11 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
19 services19 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
16 services16 patients
Nursing facility discharge management, more than 30 minutes 99316
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
14 services14 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
13 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140011
Location201 S 14th StHerrin, IL 62948 · Williamson County
Emergency services

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140164
Location405 W JacksonCarbondale, IL 62901 · Jackson County
Emergency services Birthing friendly

St Joseph Memorial Hospital

Critical Access Hospitals · Murphysboro, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141334
Location2 South Hospital DriveMurphysboro, IL 62966 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60439 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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

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

BROADMED LLC
General Acute Care Hospital
14268 LACEY DR
LEMONT, IL 60439
Dupage County (630) 414-9335

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 Jeffrey Sam's NPI number?

The NPI number for Jeffrey Sam is 1912588138. It was assigned to this individual provider in the NPPES registry on April 19, 2021.

Where is Jeffrey Sam located?

Jeffrey Sam practices at 14268 Lacey Dr, Lemont, IL 60439. The listed phone number is (630) 414-9335.

What is Jeffrey Sam's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jeffrey Sam enrolled in Medicare?

Yes. Jeffrey Sam 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.

Which organization bills Medicare for Jeffrey Sam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Sam reassigns Medicare benefits to 24 On Physicians, PC (Ottawa, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeffrey Sam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jeffrey Sam affiliated with any hospitals?

According to CMS data, Jeffrey Sam is affiliated with Herrin Hospital, Memorial Hospital Of Carbondale and St Joseph Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jeffrey Sam was last updated on August 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.