Active NPI
Phyllis Lee, MD
- Family Medicine Physician
- Oshkosh, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 40466-020
- Practice address
- 855 N Westhaven Dr
Oshkosh, WI 54904-7668 - Phone
- (920) 303-8700
- Fax
- (920) 456-5901
- NPI assigned
- Aug 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 40466-020 | WI | Primary |
| Surgery Physician | 208600000X | 40466-020 | WI |
Addresses
Primary practice location
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32476700 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | plee43726@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40466-020 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aamg Reach PLLC | Family Medicine | Current | Accepting new patients |
Locations
10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000
855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Evergreen Health Center | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2024 Jan 1, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- Oshkosh, WI
- NPI 1144213281
Adp of the SNF, Operational/Managerial Control
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1124010749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 N WESTHAVEN DR",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549047668",
"telephone_number": "920-303-8700",
"fax_number": "920-456-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PHYLLIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-19",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "40466-020",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "40466-020",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32476700",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "plee43726@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "855 N Westhaven Dr",
"city": "Oshkosh",
"state": "WI",
"country_code": "US",
"postal_code": "549047668",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "855 N Westhaven Dr",
"city": "Oshkosh",
"state": "WI",
"country_code": "US",
"postal_code": "549047668",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.