Individual provider Active NPI

Si Won Lee, MD

  • Reproductive Endocrinology Physician
  • Rochester, MN
National Provider Identifier
1164913208
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
70697 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Reproductive Endocrinology Physician 207VE0102X 70697 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

4300 Alton Rd
Miami Beach, FL 33140-2948

Other practice location 1

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 674-2310

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slee1745242@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220725001494 MN Practitioner - Obstetrics/Gynecology 2062893860 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70697MNMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Jul 1, 2022 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2022 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: slee1745242@ehrdirect.mayoclinicmsg.org

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1164913208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331402948",
            "country_code": "US",
            "telephone_number": "305-674-2310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SI WON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MN",
            "license": "70697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slee1745242@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.