Individual provider Active NPI

Edward K Lee, DO

  • Radiation Oncology Physician
  • East Grand Rapids, MI
National Provider Identifier
1013930577
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
5101007580 Issued in MI
Practice address
1840 Wealthy St SE
East Grand Rapids, MI 49506-2921
Phone
(616) 774-7845
Fax
(616) 774-5146
NPI assigned
Jul 25, 2006
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 5101007580 MI Primary

Addresses

Primary practice location

1840 Wealthy St SE
East Grand Rapids, MI 49506-2921

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1830

Other practice location 1

145 Michigan St NE Ste 1100
Grand Rapids, MI 49503-2562
Phone (616) 486-5750

Other identifiers 2

IdentifierTypeStateIssuer
920004946OtherMIRAILROAD MEDICARE
4148311MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604001151 MI Practitioner - Radiation Oncology 4082786330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Michigan State University College of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Healthcare, PLLCGroup PAC ID 6002045895, 23 clinicians

Practice addresses (Care Compare)

1625 Ramblewood Dr
Suite 1
East Lansing, MI 48823-6367
Phone (517) 324-3700

2175 Coolidge Rd
East Lansing, MI 48823-1379
Phone (517) 999-5900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101007580MIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Healthcare PLC CurrentSince Apr 29, 2014 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Nov 1, 2025 Accepting new patients
Compass Healthcare, PLLC Radiation Oncology CurrentSince Apr 29, 2014 Accepting new patients
Lakeshore Area Radiation Oncology Center Past Accepting new patients
Michigan MRT Holdings, LLC Radiation Oncology PastSince Jun 8, 2025 Accepting new patients

Locations

1575 Ramblewood Dr
Ste 100
East Lansing, MI 48823
Phone (517) 364-3659

1625 Ramblewood Dr
Ste 1
East Lansing, MI 48823
Phone (517) 324-3700

2175 Coolidge Rd
East Lansing, MI 48823
Phone (517) 349-1379

2175 Coolidge Rd
Ste 200
East Lansing, MI 48823
Phone (517) 999-5900

6255 Inkster Rd
Ste 307
Garden City, MI 48135
Phone (248) 556-5582

145 Michigan St NE
Ste 3100
Grand Rapids, MI 49503
Phone (616) 954-9800

5800 Foremost Dr SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 389-1800

18223 E 10 Mile Rd
Ste 100
Roseville, MI 48066
Phone (586) 778-5880

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1013930577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-1830",
            "fax_number": "616-391-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 WEALTHY ST SE",
            "city": "EAST GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062921",
            "telephone_number": "616-774-7845",
            "fax_number": "616-774-5146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Michigan St NE Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032562",
            "country_code": "US",
            "telephone_number": "616-486-5750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EDWARD",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "5101007580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "920004946",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4148311",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.