Ki Nyoung Lee, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

D0023473 Issued in MD

Practice address

3947 Ferrara Drive
Wheaton, MD 20906-4709

Phone

(301) 942-9004

Fax

(301) 942-9004

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

AnesthesiologyAlso: General Practice

Education

Other, 1966

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255498028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9806 SORREL AVE",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "20854",
            "telephone_number": "301-299-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3947 FERRARA DRIVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209064709",
            "telephone_number": "301-942-9004",
            "fax_number": "301-942-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KI",
        "middle_name": "NYOUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D0023473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "555625",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "975221800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter J Kotz, ATC
• Sarah Calvert Lartey, CPNP-PC
• Mary Patricia Lazarek, CRNP
• Chul J Lee, MD
• Jean H Lee, MD
• Danielle Nicole Leff
• Samuel Harris Leibowitz, M.D.
• Dawn Johnson Leonard, M.D.
• Allan Lesser, MD
• Meghan Lewis, DPT

• Pain Medicine (Anesthesiology) Physician in Wheaton, MD
• Providers in Wheaton, MD by specialty
• Pain Medicine (Anesthesiology) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.