Individual provider Active NPI

Lee R Bittenbender, MD

  • Dermatology Physician
  • Lawrence, KS
National Provider Identifier
1154420263
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
15200 Issued in 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
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 15200 KS Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20080416000168 KS Practitioner - Dermatology 4587742572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15200KSMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew 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 PastSince Feb 23, 2020 Accepting new patients

Locations

11550 Granada St
Leawood, KS 66211
Phone (913) 451-7546

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJICCA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1154420263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SW 6TH AVE STE 104",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061707",
            "telephone_number": "785-354-8518",
            "fax_number": "785-354-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 CLINTON PL STE C",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472213",
            "telephone_number": "785-331-4488",
            "fax_number": "785-331-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITTENBENDER",
        "first_name": "LEE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "15200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.