Chung Seng Lee, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

01029687A Issued in IN

Practice address

2622 Lake Ave
Fort Wayne, IN 46805-5410

Phone

(260) 425-3100

Fax

(260) 425-3604

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1093718249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055410",
            "telephone_number": "260-425-3100",
            "fax_number": "260-425-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055410",
            "telephone_number": "260-425-3100",
            "fax_number": "260-425-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHUNG",
        "middle_name": "SENG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01029687A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055070",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110002008",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480939",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Grace Lee, OD
• Audrey Lee
• Bohyung Ken Lee, MD
• Brian J Lee, MD
• Britini Danial Lee
• Daria B. Lee, M.D.
• Ford W. Lee, NP
• Jared Lee
• Jillian Lee
• Jonathan C Lee, M.D.

• Gastroenterology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.