Individual provider Active NPI

Keith Alan Lee

  • Internal Medicine Physician
  • Wynnewood, PA
National Provider Identifier
1326740689
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS025753 Issued in PA
Practice address
100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone
(484) 476-2000
NPI assigned
Mar 20, 2023
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X OS025753 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 476-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260601001127 PA Practitioner - Internal Medicine 0547621310

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-8820

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Internal Medicine CurrentSince Jul 1, 2026 Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

100 E Lancaster Ave
Ste B
Wynnewood, PA 19096
Phone (484) 476-1333

Organizations & group practices 1

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 1

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1326740689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KEITH",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS025753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.