Individual provider Active NPI

Sandra Lee, MD

  • Emergency Medicine Physician
  • Goshen, NY
National Provider Identifier
1366450850
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
201832 Issued in NY
Practice address
1 Hatfield LN
Goshen, NY 10924-6752
Phone
(845) 360-5530
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 201832 NY Primary

Addresses

Primary practice location

1 Hatfield LN
Goshen, NY 10924-6752

Mailing address

1 Hatfield LN
Goshen, NY 10924-6752

Other identifiers 1

IdentifierTypeStateIssuer
01990207MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20060111000101 NJ Practitioner - Emergency Medicine 5496737116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prompt MD LLCGroup PAC ID 9739236779, 4 clinicians
Adam Alex LLCGroup PAC ID 3274859376, 4 clinicians

Practice addresses (Care Compare)

309 1St St
Hoboken, NJ 07030-2440
Phone (201) 222-8411

725 River Rd
Suite 27
Edgewater, NJ 07020-1149
Phone (201) 941-1555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20832NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Alex, LLC CurrentSince May 4, 2016 Accepting new patients
Prompt MD LLC CurrentSince May 4, 2016 Accepting new patients
Eos Medical Group PC Emergency Medicine Past Accepting new patients

Locations

725 River Rd
Ste 27
Edgewater, NJ 07020
Phone (201) 500-9877

309 1st St
Hoboken, NJ 07030
Phone (201) 222-8411

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1366450850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HATFIELD LN",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HATFIELD LN",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246752",
            "telephone_number": "845-360-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "201832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01990207",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.