Individual provider Active NPI

Simon Lee, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Warrenville, IL
National Provider Identifier
1477933497
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
036156602 Issued in IL
Practice address
27650 Ferry Rd
Warrenville, IL 60555-3845
Phone
(630) 225-2663
Fax
(302) 252-3996
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301107561 MI
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036156602 IL Primary

Addresses

Primary practice location

27650 Ferry Rd
Warrenville, IL 60555-3845

Mailing address

27650 Ferry Rd
Warrenville, IL 60555-3845
Phone (630) 225-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20210719002724 IL Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8527376201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Chicago College of Medicine and Surgery, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

27650 Ferry Rd
Warrenville, IL 60555-3845
Phone (630) 225-2663

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Marianjoy Rehabilitation Center Inpatient rehabilitation facility, Wheaton, IL, CCN 143027

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)25
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Orthopaedic Surgery CurrentSince Aug 16, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 16, 2021 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

27650 Ferry Rd
Warrenville, IL 60555
Phone (630) 225-2345

27650 Ferry Rd
Ste 100
Warrenville, IL 60555
Phone (630) 225-2455

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

1500 E Medical Center Dr
Spc 5328
Ann Arbor, MI 48109
Phone (734) 232-6343

Organizations & group practices 3

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 4

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1477933497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27650 FERRY RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553845",
            "telephone_number": "630-225-2663",
            "fax_number": "302-252-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27650 FERRY RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553845",
            "telephone_number": "630-225-2663",
            "fax_number": "302-252-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301107561",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036156602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.