Individual provider Active NPI

Colin D Lee, MD

  • Interventional Cardiology Physician
  • Wailuku, HI
National Provider Identifier
1629005434
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
M7488 Issued in ID
Practice address
221 Mahalani Street
Wailuku, HI 96793-2526
Phone
(808) 244-9056
Fax
(208) 322-1695
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X M7488 ID Primary

Addresses

Primary practice location

221 Mahalani Street
Wailuku, HI 96793-2526

Mailing address

221 Mahalani Street
Physician Practice Services
Wailuku, HI 96793-2526
Phone (808) 242-2528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20110202000039 HI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6406803063 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7488IDMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jul 1, 2017 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jul 1, 2017 Accepting new patients
Idaho Cardiology Associates PA Interventional Cardiology Past Accepting new patients
Gooding County Hospital District Past Accepting new patients
West Valley Professional Fee Billing, LLC Past Accepting new patients

Locations

85 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 442-5700

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1629005434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAHALANI STREET",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-242-2528",
            "fax_number": "808-442-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-244-9056",
            "fax_number": "208-322-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "COLIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ID",
            "license": "M7488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.