Active NPI
Diane Lee
- Dermatology Physician
- Bethlehem, PA
National Provider Identifier
1215638077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MT232716
- Practice address
- 801 Ostrum St
Bethlehem, PA 18015-1000 - Phone
- (484) 526-4644
- Fax
- (484) 526-4920
- NPI assigned
- Mar 16, 2023
- Last updated
- Jun 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MT232716 | PA | Primary |
Addresses
Primary practice location
801 Ostrum St
Bethlehem, PA 18015-1000
Mailing address
3500 N Broad St
Philadelphia, PA 19140-4106
Other practice location 1
3500 N Broad St
Philadelphia, PA 19140-4106
Phone (603) 770-3014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240906003834 | PA | Order and Referring Only - Internal Medicine | 2365982154 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT232716 | PA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1215638077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 OSTRUM ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180151000",
"telephone_number": "484-526-4644",
"fax_number": "484-526-4920"
}
],
"practiceLocations": [
{
"address_1": "3500 N Broad St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191404106",
"country_code": "US",
"telephone_number": "603-770-3014",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "DIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-16",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "MT232716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.