Active NPI
Madeline Anderson Lee, PA
- Medical Physician Assistant
- Mount Pleasant, SC
National Provider Identifier
1356096994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 4155
- Practice address
- 912 Old Georgetown Road
Mt. Pleasant, SC 29464 - Phone
- (843) 216-3530
- NPI assigned
- Feb 12, 2022
- Last updated
- Apr 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 4155 | SC | Primary |
Addresses
Primary practice location
912 Old Georgetown Road
Mt. Pleasant, SC 29464
Mailing address
1215 Springhill Rd
Hanahan, SC 29410-2027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4155 | Other | SC | SC LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
912 Old Georgetown Rd
Mount Pleasant, SC 29464-4175
Phone (843) 216-3530
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- manderson@sid.emadirect.md
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.
-
- Specialist
- Mount Pleasant, SC
- NPI 1104975663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1356096994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 SPRINGHILL RD",
"city": "HANAHAN",
"state": "SC",
"postal_code": "294102027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 OLD GEORGETOWN ROAD",
"city": "MT. PLEASANT",
"state": "SC",
"postal_code": "29464",
"telephone_number": "843-216-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MADELINE",
"middle_name": "ANDERSON",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-12",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "SC",
"license": "4155",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC LICENSE",
"identifier": "4155",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.