Individual provider Active NPI

Suji Lee

  • Nephrology Physician
  • Seattle, WA
National Provider Identifier
1245296094
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00043470 Issued in WA
Practice address
1570 N 115TH St
Suite 10
Seattle, WA 98133-8412
Phone
(206) 367-5252
Fax
(206) 367-5353
NPI assigned
Apr 21, 2006
Last updated
Aug 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00043470 WA Primary

Addresses

Primary practice location

1570 N 115TH St
Suite 10
Seattle, WA 98133-8412

Mailing address

1570 N 115TH St
Suite 10
Seattle, WA 98133-8412
Phone (206) 367-5252

Other identifiers 1

IdentifierTypeStateIssuer
8402612MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040824000080 WA Practitioner - NephrologyPractitioner - Internal Medicine 2365416542
I20191119001320 UT Practitioner - NephrologyPractitioner - Internal Medicine 2365416542 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043470WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Sep 10, 2019 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 10, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Seattle Nephrology PLLC Nephrology Past Accepting new patients
Northwest Inpatient Services Past Accepting new patients
Seattle Endocrinology Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

Interoperability endpoints

  • Direct secure messaging: suji.lee.1@13794.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1245296094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 N 115TH ST",
            "address_2": "SUITE 10",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338412",
            "telephone_number": "206-367-5252",
            "fax_number": "206-367-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 N 115TH ST",
            "address_2": "SUITE 10",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338412",
            "telephone_number": "206-367-5252",
            "fax_number": "206-367-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUJI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00043470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8402612",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.