Individual provider Active NPI

Imsook Lee, DO

  • Family Medicine Physician
  • Issaquah, WA
National Provider Identifier
1407341019
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61145112 Issued in WA
Practice address
1740 NW Maple St Ste 100
Issaquah, WA 98027-8127
Phone
(206) 520-5000
NPI assigned
Jun 26, 2018
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61145112 WA Primary

Addresses

Primary practice location

1740 NW Maple St Ste 100
Issaquah, WA 98027-8127

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other identifiers 1

IdentifierTypeStateIssuer
1407341019MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20210702001342 WA Practitioner - Family Practice 8527314491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1740 NW Maple St
Suite 100
Issaquah, WA 98027-8127
Phone (425) 391-3900

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61145112WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Family Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

1740 NW Maple St
Ste 100
Issaquah, WA 98027
Phone (425) 391-3900

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Interoperability endpoints

  • Direct secure messaging: ilee1354814@direct.ehre.uwmedicine.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1407341019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST STE 100",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "IMSOOK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61145112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407341019",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.