Gerald K Lee, M.D., PHD

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

0101057543 Issued in VA

Practice address

8551 Rixlew Lane
Suite 140
Manassas, VA 20109-4278

Phone

(703) 361-4357

Fax

(703) 361-0346

NPI assigned

Jan 9, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Jerry K Lee Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

General Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exeeda Wellness LLCGroup PAC ID 0345764957, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Altmed Medical Center, Inc

  • Addiction Medicine (Preventive Medicine) Physician
  • Manassas, VA
  • NPI 1154561389

  General Practice

  Medicare reassignment NPD Authorized official
• Exeeda Wellness LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Annandale, VA
  • NPI 1720803265

  DC

  Medicare reassignment Care Compare group NPD
• Grady Health Services Inc.

  • Occupational Medicine Clinic/Center
  • Manassas, VA
  • NPI 1841383866
  NPD Authorized official

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1184809030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2041",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201080815",
            "telephone_number": "703-361-4357",
            "fax_number": "703-361-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 RIXLEW LANE",
            "address_2": "SUITE 140",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094278",
            "telephone_number": "703-361-4357",
            "fax_number": "703-361-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GERALD",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MD",
            "license": "D0054211",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101057543",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "01010575543",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0054211",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "VA",
            "license": "0101057543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "182042",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "LEE",
            "middle_name": "K",
            "credential": "M.D., PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Audrey Le, PHARM.D.
• Leap Ahead, Inc.
• Linda R Ledbetter, ANP-BC
• Alexander Charles Lee, PA-C
• Bayley Lee, LPC
• Grace E Lee, APRN, MSN, PMHNP
• Jay Lee
• Jennifer Marie Lee, MS, CCC-SLP
• Johanna-Marie Jaboneta Lee, LPC
• Justus Lee

• Addiction Medicine (Internal Medicine) Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Addiction Medicine (Internal Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.