Shuishih Sage Lee

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

01029326A Issued in IN

Practice address

2200 Randallia Dr
Ft Wayne, IN 46805-4638

Phone

(800) 899-5757

NPI assigned

Dec 1, 2005

Last updated

Sep 10, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Allied Hospital Pathologists, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Wayne, IN
  • NPI 1831175389
  NPD
• Fort Wayne Medical Laboratory Corporation

  • Medical Laboratory Technician
  • Fort Wayne, IN
  • NPI 1285610733

  Anatomic Pathology & Clinical Pathology

  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1386628576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-424-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDALLIA DR",
            "city": "FT WAYNE",
            "state": "IN",
            "postal_code": "468054638",
            "telephone_number": "800-899-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SHUISHIH",
        "middle_name": "SAGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01029326A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100364200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Lee
• Jonathan C Lee, M.D.
• Michael D Lee, MD
• Rebecca L Lee, PHARM.D
• Samuel Lee, DO
• Steven B Lee, DDS
• Vashon Lee, COTA/L
• Rebekah Marie Leemreis, MA, BCBA
• Cassandra Leeper, PHARMD
• Christopher A Leeuw, DPT

• Anatomic Pathology & Clinical Pathology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.