DR. SAM LEE OD
NPI 1922779404
Optometrist in Berkeley, CA

Q: What is Sam Lee's NPI number?

The NPI number for Sam Lee is 1922779404. It was assigned to this individual provider in the NPPES registry on September 23, 2021.

Q: What is Sam Lee's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Sam Lee was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 September 23, 2021PECOS EnrolledAccepts Medicare Assignment

3100 SAN PABLO AVE FL 4, BERKELEY, CA 94702(415) 353-8299 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 8, 2025, Sep 23, 2021 (2 updates tracked since 2021).

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About Dr. Sam Lee Od NPPES

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

DR. SAM LEE OD (NPI 1922779404) is an individual optometrist in Berkeley, California, licensed in California (34986) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS and is a graduate of State University Of New York - State College Optometry (2021).

NPPES Registry Identity

NPI1922779404

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. SAM LEECredential: OD

Location Address3100 SAN PABLO AVE FL 4Berkeley, CA 94702-2498

Mailing Address17806 Sycamore AvePatterson, CA 95363-9336

Phone(415) 353-8299

Sole ProprietorYes

Medical School CMSState University Of New York - State College OptometryGraduated 2021

Enumeration DateSeptember 23, 2021

Last NPPES UpdateApril 8, 20252 updates tracked since enumeration

NPPES CertifiedApril 8, 2025

✔ NPI 1922779404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CA · 34986

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

3100 SAN PABLO AVE FL 4, Berkeley, CA 94702

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Dr. Sam Lee Od 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 ID143618934

PECOS Enrollment IDI20211027003257

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94702 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

$153.83 typical visit price

range $69.00 – $202.35

Typical copayment $38.45 (range $17.25 – $50.58)

Most-billed visit code 99204

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

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.

Other Providers at the Same Location NPPES

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

DR. BROOKE IRENE REID AU.D.

Audiologist

3100 SAN PABLO AVE FL 4
BERKELEY, CA 94702

Alameda County (510) 985-5200

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 Sam Lee's NPI number?

The NPI number for Sam Lee is 1922779404. It was assigned to this individual provider in the NPPES registry on September 23, 2021.

Where is Sam Lee located?

Sam Lee practices at 3100 San Pablo Ave Fl 4, Berkeley, CA 94702. The listed phone number is (415) 353-8299.

What is Sam Lee's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Sam Lee enrolled in Medicare?

Yes. Sam Lee 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 Sam Lee accept?

Health plans from Providence Health Plan list Sam Lee 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.

When was this NPI record last updated?

The NPPES record for Sam Lee was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.