NPIMap

Individual provider Active NPI

Robert DM Lee, M.D.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1225031925
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01039479A Issued in IN
Practice address
2102 E Inwood Rd
South Bend, IN 46614-2443
Phone
(574) 299-2400
Fax
(574) 299-2410
NPI assigned
May 27, 2005
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01039479A IN Primary

Addresses

Primary practice location

2102 E Inwood Rd
South Bend, IN 46614-2443

Mailing address

2102 E Inwood Rd
South Bend, IN 46614-2443
Phone (574) 299-2400

Other identifiers 2

IdentifierTypeStateIssuer
100114340AMedicaidIN
100143040MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100824001058 IN Practitioner - Family Practice 9436151701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

2102 E Inwood Rd
South Bend, IN 46614-2443
Phone (574) 234-8161

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic LLC CurrentSince May 1, 2012 Accepting new patients
The South Bend Clinic, LLC CurrentSince May 1, 2012 Accepting new patients
Privia Medical Group Indiana, LLC PastSince Mar 1, 2001 Accepting new patients

Locations

303 S Nappanee St
Elkhart, IN 46514

2102 E Inwood Rd
South Bend, IN 46614
Phone (574) 299-2400

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Interoperability endpoints

  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
  • Direct secure messaging: rlee254102@dulyhealthandcare.direct-ci.com

Organizations & group practices 3

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 6

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1225031925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 E INWOOD RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142443",
            "telephone_number": "574-299-2400",
            "fax_number": "574-299-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E INWOOD RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142443",
            "telephone_number": "574-299-2400",
            "fax_number": "574-299-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROBERT",
        "middle_name": "DM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01039479A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114340A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100143040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.