Individual provider Active NPI

Chong S. Lee, M.D.

  • Surgery Physician
  • Norfolk, VA
National Provider Identifier
1497818025
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD191833 Issued in OR
Practice address
155 Kinglsey Lane Suite 405
Bon Secours Surgical Specialists
Norfolk, VA 23505
Phone
(757) 278-2220
Fax
(757) 489-0701
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60920799 WA
Colon & Rectal Surgery Physician 208C00000X 4301064070 MI
Surgery Physician 208600000X MD191833 OR Primary

Addresses

Primary practice location

155 Kinglsey Lane Suite 405
Bon Secours Surgical Specialists
Norfolk, VA 23505

Mailing address

PO Box 2847
Corvallis, OR 97339-2847

Other practice location 1

930 SW Abbey St Ste B
Newport, OR 97365-4820
Phone (541) 574-7235

Other identifiers 1

IdentifierTypeStateIssuer
2155620MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clee208156@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190726000462 OR Practitioner - General Surgery 5597895359 Reassigns benefits to 3 organizations
I20210413001338 WA Practitioner - General Surgery 5597895359 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Mountain Hospital District CurrentSince Jun 6, 2022 Accepting new patients
Bay Area Hospital District CurrentSince Jun 25, 2019 Accepting new patients
Blue Mountain Hospital District CurrentSince Jun 6, 2022 Accepting new patients
Bay Area Hospital District CurrentSince Jun 25, 2019 Accepting new patients
Multicare Health System CurrentSince Feb 2, 2022 Accepting new patients
Multicare Health System CurrentSince Feb 2, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Maryview Hospital Past Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

170 Ford Rd
John Day, OR 97845
Phone (541) 575-1311

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4fb2ef4c-fc22-4675-b38f-5641155a5454/

Organizations & group practices 8

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1497818025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2847",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973392847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 KINGLSEY LANE SUITE 405",
            "address_2": "BON SECOURS SURGICAL SPECIALISTS",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23505",
            "telephone_number": "757-278-2220",
            "fax_number": "757-489-0701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 SW Abbey St Ste B",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654820",
            "country_code": "US",
            "telephone_number": "541-574-7235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHONG",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60920799",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "4301064070",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD191833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155620",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clee208156@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St Ste B",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.