Individual provider Active NPI

Michael Joe Lee, MD

  • Internal Medicine Physician
  • Banning, CA
National Provider Identifier
1528277688
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A106425 Issued in CA
Practice address
1169 W Ramsey St
Banning, CA 92220-4443
Phone
(951) 849-1543
NPI assigned
May 22, 2007
Last updated
Jun 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A106425 CA Primary

Addresses

Primary practice location

1169 W Ramsey St
Banning, CA 92220-4443

Mailing address

1169 W Ramsey St
Banning, CA 92220-4443
Phone (951) 849-1543

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0022659OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110107000757 CA Practitioner - Internal Medicine 1850580788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

81833 Doctor Carreon Blvd
Suite 8
Indio, CA 92201-5590
Phone (760) 863-1888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106425CAMDDentist
A106425CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Medical Specialists Inc Internal Medicine CurrentSince Aug 2, 2010 Accepting new patients

Locations

1169 W Ramsey St
Banning, CA 92220
Phone (951) 849-1543

81833 Doctor Carreon Blvd
Ste 8
Indio, CA 92201
Phone (760) 863-1888

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1528277688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922204443",
            "telephone_number": "951-849-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922204443",
            "telephone_number": "951-849-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "middle_name": "JOE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A106425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0022659",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.