Individual provider Active NPI

Kit Shan Lee, MD

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1346502358
Registry record updated Mar 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-19481 Issued in HI
Practice address
1319 Punahou St Ste 1150
Honolulu, HI 96826-1001
Phone
(808) 983-6053
NPI assigned
Jun 14, 2012
Last updated
Mar 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 50734 AZ
Pediatrics Physician 208000000X R73268 AZ
Pediatrics Physician 208000000X MD-19481 HI Primary

Addresses

Primary practice location

1319 Punahou St Ste 1150
Honolulu, HI 96826-1001

Mailing address

1319 Punahou St Ste 1150
Honolulu, HI 96826-1080
Phone (808) 983-6053

Other practice location 1

5750 E Highway 90
Ste 375
Sierra Vista, AZ 85635-9110
Phone (520) 263-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20180327002938 HI Practitioner - Pediatric Medicine 1658689401 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50734AZMDPediatrics Physician
R73268AZMDPediatrics Physician
MD-19481HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kapiolani Medical Specialists CurrentSince Mar 26, 2018 Accepting new patients
Kapiolani Medical Center Past Accepting new patients

Locations

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

1319 Punahou St
Ste 1150
Honolulu, HI 96826
Phone (808) 946-1481

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1346502358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST STE 1150",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261080",
            "telephone_number": "808-983-6053",
            "fax_number": "808-983-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST STE 1150",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-983-6053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 E Highway 90",
            "address_2": "Ste 375",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856359110",
            "country_code": "US",
            "telephone_number": "520-263-3500",
            "fax_number": "520-263-3597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KIT SHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "50734",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R73268",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-19481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.