Individual provider Active NPI

Siemay Chang Lee, MD

  • Internal Medicine Physician
  • Greeley, CO
National Provider Identifier
1497966824
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0052999 Issued in CO
Practice address
6767 West 29TH Street
2ND Floor
Greeley, CO 80634-5474
Phone
(970) 652-2433
Fax
(970) 652-2252
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11789 NV
Internal Medicine Physician 207R00000X DR.0052999 CO Primary

Addresses

Primary practice location

6767 West 29TH Street
2ND Floor
Greeley, CO 80634-5474

Mailing address

6767 West 29TH Street
2ND Floor
Greeley, CO 80634-5474
Phone (970) 652-2433

Other practice location 1

1900 16th St
Greeley, CO 80631-5114
Phone (970) 350-2413

Other identifiers 1

IdentifierTypeStateIssuer
19052863MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20140613000773 CO Practitioner - Internal Medicine 0840386488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

11083 Colorado Blvd
Firestone, CO 80504-5873
Phone (303) 833-8880

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2121 E Harmony Rd
Fort Collins, CO 80528-3401

2450 S Peoria
Aurora, CO 80014-5475

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4674 Snow Mesa Dr
Suite 200
Fort Collins, CO 80528-8614
Phone (970) 495-8450

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

  • Accentcare Home Health of Mountain Valley LLC Home health agency, Denver, CO, CCN 067445
  • Optimal Home Care Loveland Home health agency, Loveland, CO, CCN 067546
  • Banner Home Care Colorado Home health agency, Greeley, CO, CCN 067147
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0052999COMDInternal Medicine Physician
11789NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 1, 2014 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

2450 S Peoria St
Ste 245
Aurora, CO 80014
Phone (303) 752-7732

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

6767 29th St
Ste 2
Greeley, CO 80634

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

6767 29th St
#2
Greeley, CO 80634

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1497966824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 WEST 29TH STREET",
            "address_2": "2ND FLOOR",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2433",
            "fax_number": "970-652-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 WEST 29TH STREET",
            "address_2": "2ND FLOOR",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2433",
            "fax_number": "970-652-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 16th St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806315114",
            "country_code": "US",
            "telephone_number": "970-350-2413",
            "fax_number": "970-350-2473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SIEMAY",
        "middle_name": "CHANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11789",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0052999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19052863",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.