Active NPI
Hanna Lee, D.O.
- Pediatrics Physician
- Shelton, CT
National Provider Identifier
1538519939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 72525
- Practice address
- 25 Constitution Blvd S
Shelton, CT 06484-4351 - Phone
- (203) 924-7334
- NPI assigned
- Jun 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OT017312 | PA | |
| Pediatrics Physician | 208000000X | 72525 | CT | Primary |
| Pediatric Infectious Diseases Physician | 2080P0208X | 71858 | CT |
Addresses
Primary practice location
25 Constitution Blvd S
Shelton, CT 06484-4351
Mailing address
25 Constitution Blvd S
Shelton, CT 06484-4351
Phone (203) 924-7334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160811000874 | PA | Order and Referring Only - Pediatric Medicine | 0143514364 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT017312 | PA | MD | Family Medicine Physician |
| 72525 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Care Associates of Connecticut | Past | Accepting new patients |
Interoperability endpoints
- hlee571195@direct.ynhh.org
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 and National Provider Directory roles.
-
- Pediatric Adolescent Medicine Physician
- Shelton, CT
- NPI 1396867958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758585600000",
"number": "1538519939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CONSTITUTION BLVD S",
"city": "SHELTON",
"state": "CT",
"postal_code": "064844351",
"telephone_number": "203-924-7334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 CONSTITUTION BLVD S",
"city": "SHELTON",
"state": "CT",
"postal_code": "064844351",
"telephone_number": "203-924-7334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "HANNA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-16",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OT017312",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "72525",
"primary": true
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "CT",
"license": "71858",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shelton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.