Individual provider Active NPI

Benjamin Lee, D.O.

  • Cardiovascular Disease Physician
  • Stayton, OR
National Provider Identifier
1053745943
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
DO187114 Issued in OR
Practice address
1401 N 10TH Ave Ste 200
Stayton, OR 97383-1487
Phone
(503) 769-9118
NPI assigned
Aug 27, 2013
Last updated
Mar 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X DO187114 OR Primary

Addresses

Primary practice location

1401 N 10TH Ave Ste 200
Stayton, OR 97383-1487

Mailing address

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414
Phone (323) 268-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20181017002598 OR Practitioner - Cardiovascular Disease (Cardiology) 5991057028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO187114ORMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince Sep 1, 2018 Accepting new patients
Santiam Memorial Hospital Single Specialty Current Accepting new patients
Santiam Memorial Hospital CurrentSince Sep 1, 2018 Accepting new patients
Santiam Memorial Hospital Past Accepting new patients

Locations

1371 N 10th Ave
Stayton, OR 97383
Phone (503) 769-1605

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1401 N 10th Ave
Ste 200
Stayton, OR 97383
Phone (503) 769-7151

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: blee@santiam.securechart.com

Organizations & group practices 4

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 3

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": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1053745943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332414",
            "telephone_number": "323-268-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE STE 200",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831487",
            "telephone_number": "503-769-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "DO187114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.