Individual provider Active NPI

Myung-Sang Lee, MD

  • Anesthesiology Physician
  • Mequon, WI
National Provider Identifier
1235157702
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
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

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
068715OtherHEALTH 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

LicenseStateTypeSpecialty
036-057960ILMDAnesthesiology 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.

Verify at the official NPI Registry.