NPIMap

Individual provider Active NPI

Edmund Wing-Lam Lee

  • Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1578958997
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
317361 Issued in NY
Practice address
101 Nicolls Rd Dept of
Stony Brook, NY 11794-3307
Phone
(631) 689-8333
NPI assigned
Apr 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 317361 NY Primary

Addresses

Primary practice location

101 Nicolls Rd Dept of
Stony Brook, NY 11794-3307

Mailing address

3300 Gallows Rd
Falls Church, VA 22042-3307

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (732) 789-8992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220819001946 NY Practitioner - General Surgery 0244613479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317361NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Surgery CurrentSince Aug 1, 2022 Accepting new patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Past Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

23 S Howell Ave
Ste D
Centereach, NY 11720
Phone (631) 444-2274

500 Commack Rd
Ste 102A
Commack, NY 11725
Phone (631) 638-0130

280 Union Ave
Holbrook, NY 11741
Phone (631) 227-6660

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1578958997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD DEPT OF",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117943307",
            "telephone_number": "631-689-8333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "732-789-8992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EDMUND",
        "middle_name": "WING-LAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "317361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.