Individual provider Active NPI

Michael Lee

  • Emergency Medicine Physician
  • Johnson City, NY
National Provider Identifier
1609820901
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
206099 Issued in NY
Practice address
33-57 Harrison St
Johnson City, NY 13790-2107
Phone
(607) 763-6000
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME77184 FL
Emergency Medicine Physician 207P00000X MD421003 PA
Emergency Medicine Physician 207P00000X 206099 NY Primary

Addresses

Primary practice location

33-57 Harrison St
Johnson City, NY 13790-2107

Mailing address

6896 W Snowville Rd
Brecksville, OH 44141-3214

Other practice location 1

636 Del Prado Blvd S
Cape Coral, FL 33990-2668
Phone (239) 772-6513

Other practice location 2

620 E Janss Rd
Thousand Oaks, CA 91360-5113
Phone (818) 287-7409

Other identifiers 3

IdentifierTypeStateIssuer
44845OtherFLBLUE CROSS BLUE SHIELD
5978691OtherFLAETNA
256928100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AL2 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
I20080130000814 CA Practitioner - Emergency Medicine 0840192951 Reassigns benefits to 2 organizations
I20110818000405 AL Practitioner - Emergency Medicine 0840192951 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME77184FLMDEmergency Medicine Physician
206099NYMDEmergency Medicine Physician
MD421003PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Emergency Physicians LLC Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 11, 2020 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
Providence Facey Medical Foundation Current Accepting new patients
San Francisco Physicians International Medical Group, Inc Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
Trinity Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Mobile Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Prohealth Urgent Care Medicine of New Jersey LLP CurrentSince Feb 1, 2021 Accepting new patients
Cape Coral Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Physician Specialists Inc Emergency Medicine PastSince Feb 1, 2013 Accepting new patients
Clinical Laboratories of Hawaii LLP Past Accepting new patients
Best Care Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Blue Job Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Floridian Emergency Specialists, LLC Emergency Medicine PastSince Jan 26, 2020 Accepting new patients
All X Ray Diagnostic Services Corp Past Accepting new patients
North Florida Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Medicine of Florida, Inc. Past Accepting new patients
Advance Technological Radiology, PA Past Accepting new patients

Locations

800 Montclair Rd
Birmingham, AL 35213
Phone (205) 592-1000

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

26777 Agoura Rd
Ste B4
Calabasas, CA 91302
Phone (818) 880-2225

8985 Venice Blvd
Ste A3B
Los Angeles, CA 90034
Phone (424) 502-1020

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

395 Silver Spur Rd
Rolling Hills Estates, CA 90274
Phone (424) 323-3500

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

6440 Platt Ave
West Hills, CA 91307
Phone (818) 946-1103

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

1 Harmon Plz
Ste 1010
Secaucus, NJ 07094

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1751 Earl L Core Rd
Morgantown, WV 26505
Phone (304) 255-2500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1609820901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33-57 HARRISON ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902107",
            "telephone_number": "607-763-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "636 Del Prado Blvd S",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339902668",
            "country_code": "US",
            "telephone_number": "239-772-6513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 E Janss Rd",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913605113",
            "country_code": "US",
            "telephone_number": "818-287-7409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME77184",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD421003",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "206099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "44845",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5978691",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256928100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.