Individual provider Active NPI

James Lee, M.D.

  • Plastic Surgery Physician
  • Green Bay, WI
National Provider Identifier
1245204759
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
49054-020 Issued in WI
Practice address
704 S Webster Ave
Ste 401
Green Bay, WI 54301-3528
Phone
(920) 436-8284
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 0101052917 VA
Plastic Surgery Physician 208200000X 20893 WV
Plastic Surgery Physician 208200000X 49054-020 WI Primary

Addresses

Primary practice location

704 S Webster Ave
Ste 401
Green Bay, WI 54301-3528

Mailing address

704 S Webster Ave
Ste 401
Green Bay, WI 54301-3541
Phone (304) 594-2015

Other identifiers 2

IdentifierTypeStateIssuer
20893OtherWVBOARD OF MED LICENSE
0101052917OtherVABOARD OF MED LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20060320000276 WI Practitioner - Plastic and Reconstructive Surgery 9032143110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Eastern Virginia Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Bay Plastic Surgical AssocGroup PAC ID 7810911161, 2 clinicians

Practice addresses (Care Compare)

704 S Webster Ave
Green Bay, WI 54301-3528
Phone (920) 432-7433

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision27
Removal or shaving of skin growth34
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101052917VAMDPlastic Surgery Physician
49054-020WIMDPlastic Surgery Physician
20893WVMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Bay Plastic Surgical Assoc Plastic Surgery CurrentSince Apr 1, 2006 Accepting new patients
Green Bay Surgical Center Past Accepting new patients
West Virginia University Medical Corporation Past Accepting new patients

Locations

704 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-3784

704 S Webster Ave
Ste 301
Green Bay, WI 54301

704 S Webster Ave
Ste 401
Green Bay, WI 54301
Phone (414) 468-7333

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1245204759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 S WEBSTER AVE",
            "address_2": "STE 401",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013541",
            "telephone_number": "304-594-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S WEBSTER AVE",
            "address_2": "STE 401",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013528",
            "telephone_number": "920-436-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101052917",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WV",
            "license": "20893",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "49054-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF MED LICENSE",
            "identifier": "20893",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF MED LICENSE",
            "identifier": "0101052917",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.