Donghoon Lee, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

64627

Practice address

1040 Wishard Blvd
Indianapolis, IN 46202

Phone

(317) 278-1090

NPI assigned

Mar 27, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1376293860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 WISHARD BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WISHARD BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-278-1090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013656",
            "country_code": "US",
            "telephone_number": "304-691-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43 New Scotland Avenue",
            "address_2": "Department of Surgery",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12208",
            "country_code": "US",
            "telephone_number": "518-262-5374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DONGHOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "64627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Jae-Kyung Lee
• David Edward Lee, CAA
• Denise L Lee, RNC WHNP
• Derek Chalmer Lee, LMHC
• Domingo Anthony Lee, MD
• Doris M Lee, MD
• Dwight Buren Lee, D.D.S.
• Eric A Lee, M.A.
• Hanna Hae Heung Lee, PT
• Heidi H Lee, M.D.

• Student in an Organized Health Care Education/Training Program in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.