NPIMap

Organization Active NPI

Micheal T Lee MD PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Phoenix, AZ
National Provider Identifier
1366870180
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
22408 Issued in AZ
Legal business name
MICHEAL T LEE MD PC
Practice address
2222 E Highland Ave
Suite 425
Phoenix, AZ 85016-4872
Phone
(602) 667-6640
Fax
(602) 667-3305
NPI assigned
Oct 15, 2013
Last updated
Oct 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Authorized official

Name
Michael T Lee, M.D.NPI 1366536807
Title
Medical Doctor
Phone
(602) 667-6640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 22408 AZ Primary

Addresses

Primary practice location

2222 E Highland Ave
Suite 425
Phoenix, AZ 85016-4872

Mailing address

2222 E Highland Ave
Suite 425
Phoenix, AZ 85016-4872
Phone (602) 667-6640

Other identifiers 4

IdentifierTypeStateIssuer
4193000OtherAZCIGNA
AZ0830720OtherAZBLUE CROSS BLUE SHIELD
POR13LEE9MI1MedicaidAZ
1758293MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1366870180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-667-6640",
            "fax_number": "602-667-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-667-6640",
            "fax_number": "602-667-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHEAL T LEE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "602-667-6640",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "22408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4193000",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0830720",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "POR13LEE9MI1",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1758293",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.