NPIMap

Individual provider Active NPI

Soo Gil Lee, MD

  • Internal Medicine Physician
  • Amsterdam, NY
National Provider Identifier
1063476398
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
161341 Issued in NY
Practice address
5010 St Hwy 30
Ste 201
Amsterdam, NY 12010
Phone
(518) 842-7161
Fax
(518) 842-0797
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 161341 NY Primary

Addresses

Primary practice location

5010 St Hwy 30
Ste 201
Amsterdam, NY 12010

Mailing address

5010 St Hwy 30
Ste 201
Amsterdam, NY 12010
Phone (518) 842-7161

Other identifiers 1

IdentifierTypeStateIssuer
01220319MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000956 NY Practitioner - Internal MedicinePractitioner - Nephrology 7416145685 Reassigns benefits to 1 organization
Practice locations: Amsterdam, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5010 State Hwy 30
Suite 201
Amsterdam, NY 12010-7532

5010 State Hwy 30 201
Amsterdam, NY 12010-7532
Phone (518) 842-7161

Hospital & facility affiliations

  • Mohawk Valley Dialysis Center, Inc. Dialysis facility, Amsterdam, NY, CCN 332693
  • Gloversville Dialysis Center Dialysis facility, Gloversville, NY, CCN 332744
  • St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
  • Nathan Littauer Hospital Hospital, Gloversville, NY, CCN 330276
  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Merit-based Incentive Payment System (MIPS)

Final score
15.38 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
51.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC Internal Medicine CurrentSince Jul 15, 2020 Accepting new patients
Amsterdam Memorial Hospital Past Accepting new patients

Locations

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

2125 River Rd
Ste 303
Schenectady, NY 12309
Phone (518) 382-8350

Interoperability endpoints

  • Direct secure messaging: soogil.lee@zimmermanandleemds.chartmakerdirect.com

Organizations & group practices 2

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

Hospital & facility affiliations 8

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1063476398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 ST HWY 30",
            "address_2": "STE 201",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-842-7161",
            "fax_number": "518-842-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 ST HWY 30",
            "address_2": "STE 201",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-842-7161",
            "fax_number": "518-842-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SOO",
        "middle_name": "GIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "161341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01220319",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.