Tida Kumbalasiri Lee, M.D., PH.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

2022-02736 Issued in NC

Practice address

1000 Brabham Ave
Jacksonville, NC 28546-5003

Phone

(910) 937-2570

Fax

(910) 219-1270

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
• Assistedcare Home Health Inc Home health agency, Leland, NC, CCN 347224
• Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tida.lee.p1@direct.wilmingtonhealth.nextgenshare.com

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.

• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group NPD
• Wha Medical Clinic PLLC

  • Endoscopy Clinic/Center
  • Wilmington, NC
  • NPI 1083889091
  NPD
• Wilmington ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1548456478
  NPD

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

• Amedisys North Carolina, L.L.C.

  • Home Health Agency
  • Leland, NC
  • NPI 1770686586
  Care Compare affiliation
• Onslow Memorial Hospital Inc

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Care Compare affiliation
• Well Care Home Health, Inc

  • Home Health Agency
  • Wilmington, NC
  • NPI 1760470660
  Care Compare affiliation

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1619105517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRABHAM AVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465003",
            "telephone_number": "910-937-2570",
            "fax_number": "910-219-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "TIDA",
        "middle_name": "KUMBALASIRI",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101248380",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "2022-02736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lechris Health Systems of Jacksonville, Inc.
• Lechris Health Systems of Jacksonville, Inc.
• Lechris Health Systems of Jacksonville, Inc.
• Diane Cathleen Lee, PSY.D.
• Gajin Lee
• Candace Doerfler Leggett, P.T.
• Robert Michael Lenn, RN
• Sean Patrick Leonard, M.D.
• Khye Sheng Andrei Leong, M.D.
• Karolie S Lerow, CCC-SLP

• Infectious Disease Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Infectious Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.