Individual provider Active NPI

Kwang Lee

  • Anesthesiology Physician
  • Baltimore, MD
National Provider Identifier
1164497368
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0021580 Issued in MD
Practice address
2000 W Baltimore St
Baltimore, MD 21223-1558
Phone
(410) 362-3248
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0021580 MD Primary

Addresses

Primary practice location

2000 W Baltimore St
Baltimore, MD 21223-1558

Mailing address

13327 Ridgewood Dr
Ellicott City, MD 21042-1265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20090423000266 MD Practitioner - AnesthesiologyPractitioner - General Practice 6608924030 Reassigns benefits to 1 organization
Practice locations: Ellicott City, MD

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Medical Center, Inc. CurrentSince Apr 6, 2009 Accepting new patients
Grace Medical Center, Inc. Current Accepting new patients
Grace Medical Center, Inc. CurrentSince Apr 6, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Grace Medical Center, Inc. Past Accepting new patients
Grace Medical Center, Inc. Past Accepting new patients

Locations

2000 W Baltimore St
Baltimore, MD 21223
Phone (410) 362-3075

Organizations & group practices 6

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1164497368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13327 RIDGEWOOD DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231558",
            "telephone_number": "410-362-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KWANG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0021580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.