Individual provider Active NPI

Jason E Lee, DPM

  • Foot & Ankle Surgery Podiatrist
  • Erie, PA
National Provider Identifier
1144459728
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006122 Issued in PA
Practice address
5401 Peach St
Suite 3600
Erie, PA 16509-2601
Phone
(814) 868-2170
Fax
(814) 868-2108
NPI assigned
Jul 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006122 PA Primary

Addresses

Primary practice location

5401 Peach St
Suite 3600
Erie, PA 16509-2601

Mailing address

1 Lecom PL
Erie, PA 16505-2571

Other identifiers 3

IdentifierTypeStateIssuer
1027133120005MedicaidPA
1027133120001MedicaidPA
1027133120003MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000439 PA Practitioner - Podiatry 1456515949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital Foot & Ankle Surgery Current Accepting new patients
Medical Associates of Erie CurrentSince Jul 1, 2012 Accepting new patients
Medical Associates of Erie CurrentSince Jul 1, 2012 Accepting new patients
Medical Associates of Erie Current Accepting new patients

Locations

537 W 18th St
#18
Erie, PA 16502
Phone (814) 456-1009

5401 Peach St
Ste 3600
Erie, PA 16509
Phone (814) 868-2170

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

5401 Peach St
Erie, PA 16509
Phone (814) 868-2170

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

1 Lecom Pl
Erie, PA 16505

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.

NPI Registry JSON

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

{
    "created_epoch": "1246752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1144459728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 PEACH ST",
            "address_2": "SUITE 3600",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092601",
            "telephone_number": "814-868-2170",
            "fax_number": "814-868-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "E",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-05",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027133120005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027133120001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027133120003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.