Lee R Bittenbender, MD
Individual provider Active NPI Dermatology Physician · Lawrence, KS
NPI 1154420263 · NPPES record last updated Feb 17, 2020
Key facts
- NPI
- 1154420263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 15200 (KS)
- Practice address
- 3511 Clinton PL Ste C
Lawrence, KS 66047-2213 - Phone
- (785) 331-4488
- Fax
- (785) 331-4338
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080416000168 | KS | Practitioner - Dermatology | 4587742572 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15200 | KS | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skin & Mohs Surgery Center, LLC | Current | Accepting new patients | |
| Dermatology and Skin Cancer Specialists, LLC. | Dermatology | Past | Accepting new patients |
| Kansas Medical Clinic, PA | Past |
Accepting new patients |
Locations
11550 Granada St
Leawood, KS 66211
Phone (913) 451-7546
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJICCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 15200 | KS | Yes |
Addresses
Primary practice location
3511 Clinton PL Ste C
Lawrence, KS 66047-2213
Mailing address
2200 SW 6TH Ave Ste 104
Topeka, KS 66606-1707
Phone (785) 354-8518
Other providers in Lawrence, KS
- Hadley Bird
- Kevin Bird
- Madeline Grace Birdashaw
- Carol Marie Birt
- Rodney L Bishop
- Bizi4, Inc
- Blacikwell Hearing Center LLC
- Linda Blackburn
- Blanchard Psychological Services, Inc
- Christy A Blanchard
All providers in Lawrence, KS · Dermatology Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.