Active NPI
Myung-Sang Lee, MD
- Anesthesiology Physician
- Mequon, WI
National Provider Identifier
1235157702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Practice address
- 3729 W Le Grande Blvd.
Mequon, WI 53092 - Phone
- (262) 242-0699
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | IL | Primary |
Addresses
Primary practice location
3729 W Le Grande Blvd.
Mequon, WI 53092
Mailing address
3729 W Le Grande Blvd.
Mequon, WI 53092
Phone (262) 242-0699
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068715 | Other | HEALTH ALLIANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-057960 | IL | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1235157702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3729 W LE GRANDE BLVD.",
"city": "MEQUON",
"state": "WI",
"postal_code": "53092",
"telephone_number": "262-242-0699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3729 W LE GRANDE BLVD.",
"city": "MEQUON",
"state": "WI",
"postal_code": "53092",
"telephone_number": "262-242-0699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MYUNG-SANG",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "068715",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.