NPIMap

Individual provider Active NPI

Kathleen D. Lee, P.A.

  • Physician Assistant
  • South Portland, ME
National Provider Identifier
1427344795
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1736 Issued in ME
Practice address
100 Brickhill Ave
South Portland, ME 04106-1999
Phone
(207) 773-1728
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003603 VA
Physician Assistant 363A00000X PA1736 ME Primary

Addresses

Primary practice location

100 Brickhill Ave
South Portland, ME 04106-1999

Mailing address

100 Brickhill Ave
South Portland, ME 04106-1999
Phone (207) 773-1728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215002314 ME Practitioner - Physician Assistant 4284802984 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

100 Brickhill Ave
South Portland, ME 04106-1999

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315
  • Mainehealth Mid Coast Hospital Hospital, Brunswick, ME, CCN 200021

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1736MEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Oct 2, 2017 Accepting new patients
Maine Medical Partners CurrentSince Oct 2, 2017 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 2, 2017 Accepting new patients
Mainehealth CurrentSince Oct 2, 2017 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

100 Brickhill Ave
South Portland, ME 04106
Phone (207) 773-1728

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: klee182778@direct.mmc.mainehealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1427344795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-773-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-773-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KATHLEEN",
        "middle_name": "D.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003603",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.