Active NPI
Kenneth K.H. Lee, M.D.
- Internal Medicine Physician
- Honolulu, HI
National Provider Identifier
1629076427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2968
- Practice address
- 405 N Kuakini St
Suite 1004
Honolulu, HI 96817-6300 - Phone
- (808) 585-7995
- Fax
- (808) 585-7990
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2968 | HI | Primary |
Addresses
Primary practice location
405 N Kuakini St
Suite 1004
Honolulu, HI 96817-6300
Mailing address
405 N Kuakini St
Suite 1004
Honolulu, HI 96817-6300
Phone (808) 585-7995
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146911XX | Other | HI | PREFERRED CARE |
| 99-0189219 | Other | HI | TRICARE WEST |
| 00C004184-2 | Other | HI | HMSA-QUEST |
| 038114-01 | Medicaid | HI | |
| C4184-2 | Other | HI | HMSA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2968 | HI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324339200000",
"number": "1629076427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 N KUAKINI ST",
"address_2": "SUITE 1004",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968176300",
"telephone_number": "808-585-7995",
"fax_number": "808-585-7990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 N KUAKINI ST",
"address_2": "SUITE 1004",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968176300",
"telephone_number": "808-585-7995",
"fax_number": "808-585-7990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KENNETH",
"middle_name": "K.H.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2011-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "2968",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "146911XX",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE WEST",
"identifier": "99-0189219",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA-QUEST",
"identifier": "00C004184-2",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038114-01",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "C4184-2",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.