Individual provider Active NPI

Lee R. Choo-Kang, M.D.

  • Pediatric Pulmonology Physician
  • Saint Louis, MO
National Provider Identifier
1144366196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
2001007181 Issued in MO
Practice address
621 S New Ballas Rd
Suite 382-a
Saint Louis, MO 63141-8232
Phone
(314) 251-6933
Fax
(314) 251-6088
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 2001007181 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 382-a
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Suite 382-a
Saint Louis, MO 63141-8232
Phone (314) 251-6933

Other identifiers 1

IdentifierTypeStateIssuer
205387004MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040209000738 MO Practitioner - Pediatric MedicinePractitioner - Other (Physician) 4385538768 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001007181MOMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Jan 1, 2015 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 4, 2021 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jan 1, 2015 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 4, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 4, 2021 Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC PastSince Jan 23, 2012 Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

621 S New Ballas Rd
Ste 382A
Saint Louis, MO 63141
Phone (314) 251-5880

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 6006B
Saint Louis, MO 63141
Phone (314) 251-6299

1965 S Fremont Ave
Ste 130
Springfield, MO 65804
Phone (417) 820-5150

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: lchookang1232@directc.mercy.net

Organizations & group practices 7

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144366196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 382-A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6933",
            "fax_number": "314-251-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 382-A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6933",
            "fax_number": "314-251-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOO-KANG",
        "first_name": "LEE",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MO",
            "license": "2001007181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205387004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.