NPIMap

Individual provider Active NPI

Charles Kyung Chul Lee, MD

  • Plastic and Reconstructive Surgery Physician
  • San Francisco, CA
National Provider Identifier
1487635298
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A82918 Issued in CA
Practice address
1545 Pine St.
Unit 101
San Francisco, CA 94109-1078
Phone
(415) 933-8330
Fax
(415) 933-8292
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X A82918 CA Primary

Addresses

Primary practice location

1545 Pine St.
Unit 101
San Francisco, CA 94109-1078

Mailing address

1545 Pine St.
Unit 101
San Francisco, CA 94109-4682
Phone (415) 933-8330

Other identifiers 2

IdentifierTypeStateIssuer
00A829180MedicaidCA
00A829180OtherCABLUE SHIELD

Other names 1

  • Charles K. Lee Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040205001306 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General SurgeryPractitioner - Hand Surgery 7012800634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Washington University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2250 Hayes St
Suite 508
San Francisco, CA 94117-1078
Phone (415) 933-8330

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Austin SFSC, LLC CurrentSince Jul 1, 2021 Accepting new patients
San Francisco Reconstructive Plastic Surgery Inc. CurrentSince Oct 10, 2021 Accepting new patients
California Pacific Medical Group, Inc. PastSince Mar 9, 2018 Accepting new patients
University of California San Francisco Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Microsurgical Transplantation Research Foundation Past Accepting new patients
St. Mary'S Medical Center Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Seton Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: charles.lee.1@3859.direct.athenahealth.com
  • Direct secure messaging: clee161473@hisp.ehr.sutterhealth.org
  • Direct secure messaging: charles.lee.1@30614.direct.athenahealth.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1487635298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 PINE ST.",
            "address_2": "UNIT 101",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094682",
            "telephone_number": "415-933-8330",
            "fax_number": "415-933-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 PINE ST.",
            "address_2": "UNIT 101",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941091078",
            "telephone_number": "415-933-8330",
            "fax_number": "415-933-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHARLES",
        "middle_name": "KYUNG CHUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A82918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A829180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A829180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "LEE",
            "middle_name": "K.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.