NPIMap

Individual provider Active NPI

Benjamin Yanchung Lee, M.D.

  • Internal Medicine Physician
  • Havre de Grace, MD
National Provider Identifier
1306811955
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0063981 Issued in MD
Practice address
669 Revolution St
Havre de Grace, MD 21078-3319
Phone
(410) 939-2840
Fax
(410) 939-2329
NPI assigned
Feb 17, 2006
Last updated
Jul 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0063981 MD Primary
Internal Medicine Physician 207R00000X A84269 CA

Addresses

Primary practice location

669 Revolution St
Havre de Grace, MD 21078-3319

Mailing address

669 Revolution St
Havre de Grace, MD 21078-3319
Phone (410) 939-2840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000410 MD Practitioner - Internal Medicine 2860429131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

110 Baughmans LN
Suite 140
Frederick, MD 21702-4649
Phone (240) 215-1138

12 Newport Dr
Forest Hill, MD 21050-1758

301 Saint Paul St
Suite 409
Baltimore, MD 21202-2102
Phone (410) 659-7041

669 Revolution St
Havre de Grace, MD 21078-3319
Phone (410) 939-2840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84269CAMDPharmacist
A84269CAMDInternal Medicine Physician
D0063981MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Sep 6, 2016 Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Apr 5, 2017 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Apr 5, 2017 Accepting new patients
Privia Medical Group, LLC CurrentSince Sep 6, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Medical Associates of Central Virginia, Inc. Internal Medicine Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

669 Revolution St
Hvre de Grace, MD 21078
Phone (410) 939-0167

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • Direct secure messaging: benjamin.lee.1@8042.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 9

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1306811955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783319",
            "telephone_number": "410-939-2840",
            "fax_number": "410-939-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783319",
            "telephone_number": "410-939-2840",
            "fax_number": "410-939-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BENJAMIN",
        "middle_name": "YANCHUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063981",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A84269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.