Individual provider Active NPI

Wah Sang Lee, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • New York, NY
National Provider Identifier
1154355253
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
231035 Issued in NY
Practice address
17 Elizabeth St
Suite 601
New York, NY 10013-4803
Phone
(212) 966-8889
Fax
(212) 966-8815
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 231035 NY Primary
Physical Medicine & Rehabilitation Physician 208100000X 231035 NY

Addresses

Primary practice location

17 Elizabeth St
Suite 601
New York, NY 10013-4803

Mailing address

42 Bay 31St St
2ND Floor
Brooklyn, NY 11214-4110
Phone (917) 204-8780

Other identifiers 1

IdentifierTypeStateIssuer
02729124MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050929000092 NY Practitioner - Physical Medicine and RehabilitationPractitioner - Osteopathic Manipulative Medicine 4082648357 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Osteopathic Manipulative Medicine
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 Elizabeth St
Suite 601
New York, NY 10013-4803
Phone (212) 966-8889

42 Bay 31St St
Brooklyn, NY 11214-4192
Phone (212) 966-8889

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Rehabilitation Osteopathic Medicine, PLLC Neuromusculoskeletal Medicine & Omm CurrentSince Mar 18, 2007 Accepting new patients
JM Occupational Therapy,PLLC Past Accepting new patients
Holistic Pain Medicine, PC Past Accepting new patients

Locations

17 Elizabeth St
Ste 601
New York, NY 10013
Phone (212) 966-8889

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1154355253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BAY 31ST ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144110",
            "telephone_number": "917-204-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST",
            "address_2": "SUITE 601",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134803",
            "telephone_number": "212-966-8889",
            "fax_number": "212-966-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WAH",
        "middle_name": "SANG",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "231035",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "231035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02729124",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.