DR. SAM LEE OD
NPI 1922779404
Optometrist in Berkeley, CA
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, maintains a secondary practice location in Berkeley, and is a graduate of State University Of New York - State College Optometry (2021).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
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. 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.
Medicare Billing Reassignments
5Medicare enrollment records show Sam Lee reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Berkeley, CA 94720
- Reassigned Medicare billing, California enrollment
- 96 clinicians in this Medicare group
Oakland, CA 94602
- Reassigned Medicare billing, California enrollment
- 900 clinicians in this Medicare group
San Francisco, CA 94143
- Reassigned Medicare billing, California enrollment
- 5,645 clinicians in this Medicare group
San Francisco, CA 94122
- Reassigned Medicare billing, California enrollment
- 5,544 clinicians in this Medicare group
Ukiah, CA 95482
- Reassigned Medicare billing, California enrollment
- 121 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organizations bill Medicare for Sam Lee's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sam Lee reassigns Medicare benefits to 5 organizations: Regents Of The University Of California At Berkeley (Berkeley, CA), Alameda Health System (Oakland, CA), University Of California San Francisco (San Francisco, CA), Ucsf Medical Group Business Services (San Francisco, CA) and Mendocino Community Health Clinic, Inc. (Ukiah, CA). Each 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 Sam Lee's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 18 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.
# Dr. Sam Lee, OD · NPI 1922779404
Optometrist provider in Berkeley, California. Individual provider, active in the CMS NPPES registry since September 23, 2021.
## Identity
- **NPI:** 1922779404 (Entity type: Individual)
- **Enumerated:** September 23, 2021
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 34986 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3100 SAN PABLO AVE FL 4, Berkeley, CA 94702-2498
- **Phone:** (415) 353-8299
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Regents Of The University Of California At Berkeley (NPI 1306908058, Berkeley, CA); Alameda Health System (NPI 1740332931, Oakland, CA); University Of California San Francisco (NPI 1346329380, San Francisco, CA); Ucsf Medical Group Business Services (NPI 1477624104, San Francisco, CA); Mendocino Community Health Clinic, Inc. (NPI 1497961106, Ukiah, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York - State College Optometry, class of 2021
## Record status
- **NPPES last updated:** April 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1922779404) · Data from the CMS NPPES public registry.