Michael Lee, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A128109 Issued in CA

Practice address

3965 5TH Ave Ste 200
San Diego, CA 92103-3107

Phone

(619) 542-0013

Fax

(619) 542-0559

NPI assigned

Mar 29, 2012

Last updated

Apr 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Dermatology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medderm CorporationGroup PAC ID 2567465487, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michaellee@medderm.ssdirect.aprima.com

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.

• Medderm Corporation

  dba Medderm Associates

  • Dermatology Physician
  • San Diego, CA
  • NPI 1063447936
  Medicare reassignment Care Compare group
• Katrina E Woodhall, MD and Associates, a Professional Medical

  • Dermatology Physician
  • San Diego, CA
  • NPI 1043528177
  NPD (past)

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1255607685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 5TH AVE STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033107",
            "telephone_number": "619-542-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 5TH AVE STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033107",
            "telephone_number": "619-542-0013",
            "fax_number": "619-542-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A128109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maunoo Lee, MD
• Mee Kyung Lee
• Meesoo Lee
• Melinda Y Lee, M.S. R.D.
• Melissa Kyungsuh Lee
• Michael David Lee, M.D.
• Michael Jimmy Lee, M.D.
• Michael Morgan Lee, MD
• Michael Pei-Yu Lee, MD
• Michael William Lee, M.D.

• Dermatology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.