Individual provider Active NPI

Andrew Sungchurl Lee, M.D.

  • General Practice Physician
  • East Amherst, NY
National Provider Identifier
1366757486
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
265694 Issued in NY
Practice address
95 Chasewood LN
East Amherst, NY 14051-1821
Phone
(646) 384-2486
NPI assigned
Aug 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 265694 NY
General Practice Physician 208D00000X 265694 NY Primary

Addresses

Primary practice location

95 Chasewood LN
East Amherst, NY 14051-1821

Mailing address

95 Chasewood LN
East Amherst, NY 14051-1821
Phone (646) 384-2486

Other identifiers 2

IdentifierTypeStateIssuer
C167303OtherCAPHYSICIAN AND SURGEON C
265694OtherNYNYSED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240318003822 CA Practitioner - General PracticePractitioner - Orthopedic Surgery 1850738436 Reassigns benefits to 1 organization
I20240521000786 NY Practitioner - Orthopedic Surgery 1850738436 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265694NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC General Practice CurrentSince Apr 15, 2024 Accepting new patients
Signify Health Medical Associates of California, PC General Practice CurrentSince Feb 4, 2024 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1366757486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 CHASEWOOD LN",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511821",
            "telephone_number": "646-384-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CHASEWOOD LN",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511821",
            "telephone_number": "646-384-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDREW",
        "middle_name": "SUNGCHURL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-12",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "265694",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "265694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN AND SURGEON C",
            "identifier": "C167303",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYSED",
            "identifier": "265694",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.