Individual provider Active NPI

Phillip Bernhard Lee, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1134529571
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108730 Issued in FL
Practice address
217 Hillcrest St
Orlando, FL 32801-1211
Phone
(407) 425-1566
NPI assigned
Sep 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05257 NC
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA9108730 FL Primary

Addresses

Primary practice location

217 Hillcrest St
Orlando, FL 32801-1211

Mailing address

217 Hillcrest St
Orlando, FL 32801-1211
Phone (407) 425-1566

Other practice location 1

400 Celebration Pl Ste A350
Celebration, FL 34747-4970
Phone (407) 425-1566

Other practice location 2

2000 Glen Echo Rd Ste 111
Nashville, TN 37215-2857
Phone (615) 657-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150903001832 FL Practitioner - Physician Assistant 3577785195 Reassigns benefits to 1 organization
I20220621002219 TN Practitioner - Physician Assistant 3577785195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9108730FLMDPhysician Assistant
0010-05257NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jan 20, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 20, 2020 Accepting new patients
Florida Practitioners, LLC Surgical PastSince Nov 1, 2022 Accepting new patients

Locations

400 Celebration Pl
Ste A350
Kissimmee, FL 34747
Phone (407) 303-4901

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

217 Hillcrest St
Orlando, FL 32801
Phone (407) 425-1566

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: plee74050@adventhealth.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1134529571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 HILLCREST ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011211",
            "telephone_number": "407-425-1566",
            "fax_number": "407-422-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 HILLCREST ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011211",
            "telephone_number": "407-425-1566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Celebration Pl Ste A350",
            "address_purpose": "LOCATION",
            "city": "Celebration",
            "state": "FL",
            "postal_code": "347474970",
            "country_code": "US",
            "telephone_number": "407-425-1566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Glen Echo Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372152857",
            "country_code": "US",
            "telephone_number": "615-657-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "PHILLIP",
        "middle_name": "BERNHARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-03",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05257",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.