Active NPI
Katherine R Lee, M.D.
- Dermatology Physician
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 74167
- Practice address
- 3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527 - Phone
- (952) 993-2000
- NPI assigned
- May 1, 2017
- Last updated
- Jun 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dermatology Physician | 207N00000X | 74167 | MN | Primary |
| Dermatology Physician | 207N00000X | 87678 | SC | |
| Dermatology Physician | 207N00000X | 311179-01 | NY |
Addresses
Primary practice location
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Mailing address
8170 33Rd Ave S
Bloomington, MN 55425-4516
Other practice location 1
171 Ashley Ave
Charleston, SC 29425-2206
Phone (843) 792-1414
Other names 1
- Katherine R Grey
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.musc.edu | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700
250 Central Ave N
Wayzata, MN 55391-1206
Phone (952) 993-3123
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 84 |
| Removal or shaving of skin growth | 19 |
| Skin biopsy | 49 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311179-01 | NY | MD | Dermatology Physician |
| 87678 | SC | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| University Hospital at Stony Brook | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| Park Nicollet Clinic | Past | Accepting new patients |
Locations
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
7550 34th Ave S
Minneapolis, MN 55450
Phone (612) 727-1167
3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000
250 Central Ave N
Ste 103
Wayzata, MN 55391
Phone (952) 249-2000
250 Central Ave N
Ste 220
Wayzata, MN 55391
Phone (952) 993-8250
250 Central Ave N
Ste 228
Wayzata, MN 55391
Phone (952) 993-8250
100 Nicolls Rd
#8165
Stony Brook, NY 11794
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
Interoperability endpoints
- katherine.lee@direct.stonybrookmedicine.edu
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
dba MUSC Physicians
- Multi-Specialty Clinic/Center
- Charleston, SC
- NPI 1043241110
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
-
dba MUSC PHysicians
- Family Medicine Physician
- Charleston, SC
- NPI 1982678496
-
- Clinic/Center
- St Louis Park, MN
- NPI 1275232423
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1174980692
-
dba Park Nicollet Methodist Hospital Outpatient Surgery Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1194113217
-
dba PN Methodist Hospital Episodic Bundle
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1245615772
-
dba Park Nicollet Melrose Center
- Mental Illness Community Based Residential Treatment Facility
- St Louis Park, MN
- NPI 1578717336
Hospital
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1649220724
-
dba Park Nicollet Melrose Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1942585286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1386179125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 PARK NICOLLET BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162527",
"telephone_number": "952-993-2000"
}
],
"practiceLocations": [
{
"address_1": "171 Ashley Ave",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294252206",
"country_code": "US",
"telephone_number": "843-792-1414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "KATHERINE",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-01",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MN",
"license": "74167",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "SC",
"license": "87678",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "311179-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.musc.edu",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "171 Ashley Ave",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294252206",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KATHERINE",
"last_name": "GREY",
"middle_name": "R",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.