Individual provider Active NPI

CHI I Lee

  • Internal Medicine Physician
  • Holmdel, NJ
National Provider Identifier
1417924622
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA031464 Issued in NJ
Practice address
717 N Beers St
Holmdel, NJ 07733-1524
Phone
(732) 264-4900
Fax
(732) 739-2201
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA031464 NJ Primary

Addresses

Primary practice location

717 N Beers St
Holmdel, NJ 07733-1524

Mailing address

717 N Beers St
Holmdel, NJ 07733-1525
Phone (732) 264-4900

Other names 1

  • CHI I Lee Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20120711000490 NJ Practitioner - Internal Medicine 8022273374 Practice locations: Holmdel, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

717 N Beers St
Suite 1a
Holmdel, NJ 07733-1525
Phone (732) 264-4950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA031464NJMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: chilee@cilm-nj.direct.office.nextgen.com

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1417924622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 N BEERS ST",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331525",
            "telephone_number": "732-264-4900",
            "fax_number": "732-739-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N BEERS ST",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331524",
            "telephone_number": "732-264-4900",
            "fax_number": "732-739-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHI",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA031464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHI",
            "last_name": "LEE",
            "middle_name": "I",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.