Kwang Soo Lee, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

119206 Issued in NY

Practice address

221 Broadway
Suite 303
Amityville, NY 11701

Phone

(631) 789-7448

Fax

(631) 789-8571

NPI assigned

Dec 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Psychiatry

Education

Other, 1965

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bay Shore Medical Services, P.C.

  • Addiction Psychiatry Physician
  • Bay Shore, NY
  • NPI 1427379932
  NPD (past)
• Dr Marianne Hendrix MD PC

  • Psychiatry Physician
  • Smithtown, NY
  • NPI 1992980858
  NPD (past)
• Linda Low, Inc

  • Psychiatry Physician
  • Amityville, NY
  • NPI 1710047360
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1295893394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 BROADWAY",
            "address_2": "SUITE 303",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-789-7448",
            "fax_number": "631-789-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BROADWAY",
            "address_2": "SUITE 303",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-789-7448",
            "fax_number": "631-789-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KWANG",
        "middle_name": "SOO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "119206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00763828",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya Leacock, RN
• Yousline Allen Leblanc, RPH
• Margara Alina Lecca Espejo, M.D.
• Han Soo Lee, MD
• Kevin Lee, LCSW
• Melissa A. Lees, RN
• Jessie Leete, LCAT, ATR-BC
• Sharlene Legendre
• Leru Multiservice Agency
• Jacob Levy, LMSW

• Psychiatry Physician in Amityville, NY
• Providers in Amityville, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.