Individual provider Active NPI

Kevin Sunwook Lee, PA-C

  • Physician Assistant
  • Huntsville, AL
National Provider Identifier
1366143190
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.2168 Issued in AL
Practice address
927 Franklin St SE
Huntsville, AL 35801-4306
Phone
(256) 539-2728
NPI assigned
Mar 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.2168 AL Primary

Addresses

Primary practice location

927 Franklin St SE
Huntsville, AL 35801-4306

Mailing address

740 Constellation Place Dr SW
Huntsville, AL 35801-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706000943 AL Practitioner - Physician Assistant 9133588395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Health System - the Orthopaedic Center LLCGroup PAC ID 0547624843, 172 clinicians

Practice addresses (Care Compare)

104 Liberty LN
Scottsboro, AL 35769-4163
Phone (256) 539-2728

28235 Al Hwy 53
Ardmore, AL 35739-8703
Phone (256) 539-2728

927 Franklin St SE
Huntsville, AL 35801-4305
Phone (256) 539-2728

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.2168ALMDPhysician Assistant

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1366143190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 CONSTELLATION PLACE DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014306",
            "telephone_number": "256-539-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KEVIN",
        "middle_name": "SUNWOOK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.2168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.