Individual provider Active NPI

Michael Sukmin Lee, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Portland, OR
National Provider Identifier
1215932033
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
MD25478 Issued in OR
Practice address
5440 SW Westgate Dr Ste 217
Portland, OR 97221-2421
Phone
(503) 274-2121
Fax
(866) 843-7990
NPI assigned
Jun 17, 2005
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD00044319 WA
Retina Specialist (Ophthalmology) Physician 207WX0107X MD00044319 WA
Retina Specialist (Ophthalmology) Physician 207WX0107X MD25478 OR Primary
Ophthalmology Physician 207W00000X MD25478 OR

Addresses

Primary practice location

5440 SW Westgate Dr Ste 217
Portland, OR 97221-2421

Mailing address

4225 NE St James Rd
Vancouver, WA 98663-2148
Phone (503) 274-2121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlee@retinanw.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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

Enrollment IDStateProvider typePAC IDDetails
I20041217000855 OR Practitioner - Ophthalmology 1355308636 Reassigns benefits to 1 organization
I20050105000503 WA Practitioner - Ophthalmology 1355308636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Northwest PCGroup PAC ID 1254234784, 6 clinicians

Practice addresses (Care Compare)

120 NE 136TH Ave
Suite 240
Vancouver, WA 98684-6951
Phone (503) 274-2121

2105 NE 129TH St
Suite 200
Vancouver, WA 98686-3275
Phone (503) 274-2121

5050 NE Hoyt St
Suite 421
Portland, OR 97213-2984
Phone (503) 274-2121

5440 SW Westgate Dr
Suite 217
Portland, OR 97221-2421
Phone (503) 274-2121

9 Monroe Pkwy
Suite 150
Lake Oswego, OR 97035-8863
Phone (503) 274-2121

9135 SW Barnes Rd
Suite 661
Portland, OR 97225-6683
Phone (503) 274-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.78 of 100Reported as group
Quality
100
Improvement activities
40
Cost
51.82

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25478ORMDOphthalmology Physician
MD00044319WAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Northwest P.C. Ophthalmology CurrentSince Feb 1, 2005 Accepting new patients
Lee Eye Center Inc Ophthalmology Past Accepting new patients
Oh Eye Associates Inc Ophthalmology Past Accepting new patients
University Hospitals Medical Group Inc Ophthalmology Past Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

3348 Highway 101 N
Gearhart, OR 97138
Phone (503) 908-2020

9 Monroe Pkwy
Ste 150
Lake Oswego, OR 97035

3585 Broadway Ave
North Bend, OR 97459
Phone (541) 756-2584

2525 NW Lovejoy St
Ste 100
Portland, OR 97210
Phone (503) 222-2844

5050 NE Hoyt St
Ste 421
Portland, OR 97213
Phone (503) 935-8445

5440 SW Westgate Dr
Ste 217
Portland, OR 97221

9135 SW Barnes Rd
Ste 661
Portland, OR 97225

2525 NW Lovejoy St
Ste 300
Portland, OR 97210
Phone (503) 227-4050

3348 Highway 101 N
Ste D
Seaside, OR 97138

120 NE 136th Ave
Ste 240
Vancouver, WA 98684

4225 NE St James Rd
Vancouver, WA 98663

2105 NE 129th St
Ste 200
Vancouver, WA 98686
Phone (360) 573-3611

Interoperability endpoints

  • Direct secure messaging: mlee@retinanw.intellechartdirect.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1215932033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 NE ST JAMES RD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632148",
            "telephone_number": "503-274-2121",
            "fax_number": "866-843-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR STE 217",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212421",
            "telephone_number": "503-274-2121",
            "fax_number": "866-843-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "middle_name": "SUKMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00044319",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "WA",
            "license": "MD00044319",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OR",
            "license": "MD25478",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD25478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlee@retinanw.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "Nextech Direct Address",
            "address_1": "5440 SW Westgate Dr Ste 217",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972212421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.