Kisun Lee, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

DOS 1107 Issued in HI

Practice address

1441 Kapiolani Blvd FL 16
Honolulu, HI 96814-4402

Phone

(808) 432-7600

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Psychiatry

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment Care Compare group NPD
• State of Hawaii, Department of Health

  • Community/Behavioral Health Agency
  • Honolulu, HI
  • NPI 1306062690
  Medicare reassignment NPD
• State of Hawaii Department of Health

  • Psychiatry Physician
  • Honolulu, HI
  • NPI 1558223784
  NPD
• State of Hawaii Department of Health

  dba West Hawaii Community Mental Health Center- Kona

  • Community/Behavioral Health Agency
  • Kealakekua, HI
  • NPI 1720261613
  NPD
• Horizon House - Delaware Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilmington, DE
  • NPI 1881719268
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1033328695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD FL 16",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-432-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD FL 16",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-432-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KISUN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C2-0008664",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "HI",
            "license": "DOS 1107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1441 Kapiolani Blvd Fl 16",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968144402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth Shao-Sung Lee, O.D.
• Kevin L Lee, PHARM. D.
• Kevin T. Lee, PT
• Kiane Lina Lee, LMHC
• Kirby Raines Lee
• Kit Shan Lee, MD
• Kristen Lee, PHARM.D.
• Kyung Lee
• Laura Sayuri Kon Lee, RN
• Laurie Brett Lee, M.D.

• Child & Adolescent Psychiatry Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Child & Adolescent Psychiatry Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.