Individual provider Active NPI

Lee B Dittrich, MD

  • Dermatology Physician
  • Knoxville, TN
National Provider Identifier
1316905862
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
36383 Issued in TN
Practice address
123 Fox Rd
Knoxville, TN 37922-3369
Phone
(865) 690-9467
Fax
(865) 637-5057
NPI assigned
May 3, 2006
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 36383 TN Primary

Addresses

Primary practice location

123 Fox Rd
Knoxville, TN 37922-3369

Mailing address

PO Box 23329
New York, NY 10087-3329

Other identifiers 3

IdentifierTypeStateIssuer
Q007919MedicaidTN
7120405OtherTNAETNA
3874778OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040909001019 TN Practitioner - Dermatology 5395711311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Wake Forest University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Dermatology Group PCGroup PAC ID 8123009636, 29 clinicians

Practice addresses (Care Compare)

123 Fox Rd
Knoxville, TN 37922-3369
Phone (865) 690-9467

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision125
Removal of skin lesions2704
Removal of nail tissue1-10
Removal or shaving of skin growth53
Skin biopsy761

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dermatology, P.a. PastSince Jul 7, 2004 Accepting new patients
East Tennessee Dermatology Group, PC Dermatology PastSince Oct 1, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ldittrich@aadermaffiliates.emadirect.md

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1316905862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 FOX RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223369",
            "telephone_number": "865-690-9467",
            "fax_number": "865-637-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICH",
        "first_name": "LEE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "36383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007919",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7120405",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3874778",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.