Individual provider Active NPI

Robert DH Lee, MD

  • Vascular Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1184608903
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2018031906 Issued in MO
Practice address
10012 Kennerly Rd Ste 305
Saint Louis, MO 63128-2197
Phone
(314) 525-4325
NPI assigned
Dec 5, 2005
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X F89770 VA
Vascular Surgery Physician 2086S0129X 036119888 IL
Vascular Surgery Physician 2086S0129X 2018031906 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd Ste 305
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd Ste 305
Saint Louis, MO 63128-2197
Phone (314) 525-4325

Other identifiers 1

IdentifierTypeStateIssuer
036119888MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220921002777 MO Practitioner - General SurgeryPractitioner - Vascular Surgery 4981682259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1794 Zumbehl Rd
Saint Charles, MO 63303-2759
Phone (636) 947-1666

83 Progress Pkwy
Maryland Heights, MO 63043-3701
Phone (314) 434-8174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F89770VAMDSpecialist
2018031906MOMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Kansas PA CurrentSince Nov 22, 2022 Accepting new patients
American Current Care of Kansas PA Current Accepting new patients
American Current Care of Kansas PA CurrentSince Nov 22, 2022 Accepting new patients
Chong W. Lee, M.D., P.C. Vascular Surgery Past Accepting new patients
Southern Surgical Associates PLLC Vascular Surgery Past Accepting new patients
Virginia Beach Surgery, LTD Vascular Surgery Past Accepting new patients

Locations

6401 E Front St
Kansas City, MO 64120
Phone (816) 241-0603

83 Progress Pkwy
Maryland Hts, MO 63043
Phone (314) 434-8174

5506 Corporate Dr
Ste 1700
Saint Joseph, MO 64507
Phone (816) 671-4880

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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, 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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1184608903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 305",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 305",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROBERT",
        "middle_name": "DH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "F89770",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036119888",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2018031906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119888",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.