Individual provider Active NPI

Angela Young-Min Kim-Lee, M.D.

  • Forensic Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1235129180
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
D52580 Issued in MD
Practice address
711 W 40TH St
Suite 318
Baltimore, MD 21211-2120
Phone
(410) 409-5775
Fax
(410) 467-6669
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X D52580 MD Primary

Addresses

Primary practice location

711 W 40TH St
Suite 318
Baltimore, MD 21211-2120

Mailing address

6812 Koandah GDNS
Highland, MD 20777-9797
Phone (410) 409-5775

Other names 1

  • Angela Kim Lee Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20211122001890 MD Practitioner - Psychiatry 4082859574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Nebraska College of Medicine, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 W Preston St
Suite 402
Baltimore, MD 21201-2307

55 Wade Ave
Catonsville, MD 21228-4663

Spring Grove Hospital Ctr
55 Wade Avenue Medical Records
Catonsville, MD 21228-4663

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D52580MDMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comptroller of Maryland Central Payroll Bureau Current Accepting new patients
Comptroller of Maryland Central Payroll Bureau CurrentSince Jul 20, 2021 Accepting new patients
State of Maryland Central Payroll Bureau CurrentSince Jul 20, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

300 W Preston St
Ste 402
Baltimore, MD 21201
Phone (410) 767-2940

55 Wade Ave
Catonsville, MD 21228
Phone (410) 402-6000

6655 Sykesville Rd
Sykesville, MD 21784
Phone (410) 795-2100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235129180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6812 KOANDAH GDNS",
            "city": "HIGHLAND",
            "state": "MD",
            "postal_code": "207779797",
            "telephone_number": "410-409-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 318",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112120",
            "telephone_number": "410-409-5775",
            "fax_number": "410-467-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-LEE",
        "first_name": "ANGELA",
        "middle_name": "YOUNG-MIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "MD",
            "license": "D52580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "LEE",
            "middle_name": "KIM",
            "credential": "M.D., LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.