Active NPI
Susie So-Hyun Lee, M.D.
- Anesthesiology Physician
- New York, NY
National Provider Identifier
1649536384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 66890
- Practice address
- 622 W 168TH St
PH 5
New York, NY 10032-3720 - Phone
- (212) 305-2069
- NPI assigned
- Apr 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 66890 | CT | Primary |
Addresses
Primary practice location
622 W 168TH St
PH 5
New York, NY 10032-3720
Mailing address
34 Maple St
Norwalk, CT 06850-3815
Phone (203) 852-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- State University of New York Downstate Medical Center, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
24 Stevens St
Norwalk, CT 06850-3852
Phone (203) 852-2000
Hospital & facility affiliations
- Norwalk Hospital
- Danbury Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66890 | CT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Anesthesiology | Current | Accepting new patients |
| Nuvance Health Medical Practice CT, Inc. | Anesthesiology | Current | Accepting new patients |
Locations
24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118
34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000
111 E 210th St
Bronx, NY 10467
622 W 168th St
Ph 5
New York, NY 10032
Phone (212) 305-2069
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Danbury, CT
- NPI 1407898117
Anesthesiology, CT
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
Hospital & facility affiliations 6
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": "1333670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1649536384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 MAPLE ST",
"city": "NORWALK",
"state": "CT",
"postal_code": "068503815",
"telephone_number": "203-852-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"address_2": "PH 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-2069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SUSIE",
"middle_name": "SO-HYUN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-06",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CT",
"license": "66890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.