Individual provider Active NPI

Kenneth C.M. Lee, M.D.

  • Ophthalmology Physician
  • Aiea, HI
National Provider Identifier
1033291919
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD-9120 Issued in HI
Practice address
98-151 Pali Momi St
Suite 142
Aiea, HI 96701-4300
Phone
(808) 483-6400
Fax
(808) 483-6489
NPI assigned
Oct 19, 2006
Last updated
Oct 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD-9120 HI Primary

Addresses

Primary practice location

98-151 Pali Momi St
Suite 142
Aiea, HI 96701-4300

Mailing address

98-151 Pali Momi St
Suite 142
Aiea, HI 96701-4300
Phone (808) 483-6400

Other identifiers 3

IdentifierTypeStateIssuer
00C0206015OtherHIHMSA
8816444OtherHIUHA
077714MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20100518000543 HI Practitioner - Ophthalmology 1658400353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-9120HIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Dec 23, 2001 Accepting new patients
Straub Clinic & Hospital CurrentSince Dec 23, 2001 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

98-151 Pali Momi St
Ste 142
Aiea, HI 96701
Phone (808) 483-6400

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1033291919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-151 PALI MOMI ST",
            "address_2": "SUITE 142",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014300",
            "telephone_number": "808-483-6400",
            "fax_number": "808-483-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-151 PALI MOMI ST",
            "address_2": "SUITE 142",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014300",
            "telephone_number": "808-483-6400",
            "fax_number": "808-483-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNETH",
        "middle_name": "C.M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD-9120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00C0206015",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA",
            "identifier": "8816444",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077714",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.