NPIMap

Individual provider Active NPI

Major Kenneth Lee IV, MD

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1235286220
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD437590 Issued in PA
Practice address
3400 Spruce St.,
4 Silverstein
Philadelphia, PA 19104
Phone
(215) 662-2626
Fax
(314) 222-6255
NPI assigned
Jan 4, 2007
Last updated
Jun 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD437590 PA Primary

Addresses

Primary practice location

3400 Spruce St.,
4 Silverstein
Philadelphia, PA 19104

Mailing address

3400 Spruce St.,
4 Silverstein
Philadelphia, PA 19104
Phone (215) 662-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140731002815 PA Practitioner - General Surgery 2860633351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Perelman School of Med at the University of Pennsylvania, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127

3400 Civic Ctr Blvd 1
Abram Cancer Ctr Pacam 1 FLR
Philadelphia, PA 19104-5127
Phone (215) 893-2600

3400 Civic Ctr Blvd 3Rd Floor Sout
Penn Medicine Otorhinolaryngology Head and N
Philadelphia, PA 19104-5127
Phone (215) 662-2777

3400 Civic Ctr Blvd 4TH
Philadelphia, PA 19104-5127
Phone (215) 662-2626

3400 Civic Ctr Blvd 4TH Floor
Advanced Wound Healing and Lower Extremity Re
Philadelphia, PA 19104-5127
Phone (215) 662-7300

3400 Civic Ctr Blvd 4TH Floor Per
Gi Surgery Pcam
Philadelphia, PA 19104-5127
Phone (215) 662-2626

3400 Civic Ctr Blvd 4TH Floor S
Oral/Maxill Surgery Pcam
Philadelphia, PA 19104-5127
Phone (215) 662-3580

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

501 S 54TH St
Philadelphia, PA 19143-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Surgery CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Bih Radiologic Foundation Inc Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

800 Walnut St
Fl 20
William Penn Annex West, PA 19107
Phone (215) 829-2092

Organizations & group practices 5

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 7

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1235286220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.,",
            "address_2": "4 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2626",
            "fax_number": "314-222-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.,",
            "address_2": "4 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2626",
            "fax_number": "314-222-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MAJOR",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD437590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.