Individual provider Active NPI

Jonathan H Lee, M.D.

  • Otolaryngology Physician
  • Medford, OR
National Provider Identifier
1265410211
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD26131 Issued in OR
Practice address
1170 Royal Ave
Medford, OR 97504-6101
Phone
(541) 779-7331
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD26131 OR Primary

Addresses

Primary practice location

1170 Royal Ave
Medford, OR 97504-6101

Mailing address

1170 Royal Ave
Medford, OR 97504-6101
Phone (541) 779-7331

Other identifiers 2

IdentifierTypeStateIssuer
040017229OtherORRAILROAD MEDICARE
026815MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20060830000134 OR Practitioner - Otolaryngology 4880662915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Mayo Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medford Ear Nose and Throat Clinic PCGroup PAC ID 1355338013, 8 clinicians

Practice addresses (Care Compare)

1170 Royal Ave
Medford, OR 97504-6101
Phone (541) 779-7331

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision157
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26131ORMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Ear Nose and Throat Surgery CurrentSince Dec 5, 2011 Accepting new patients
Medford Ear Nose and Throat Clinic PC Otolaryngology CurrentSince Aug 1, 2006 Accepting new patients

Locations

1170 Royal Ave
Medford, OR 97504
Phone (541) 512-4771

Organizations & group practices 2

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 3

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1265410211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 ROYAL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046101",
            "telephone_number": "541-779-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 ROYAL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046101",
            "telephone_number": "541-779-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONATHAN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD26131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040017229",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026815",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.