Justin Blake Lee, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

32512 Issued in WV

Practice address

500 Cabela Dr
Triadelphia, WV 26059-1044

Phone

(681) 618-1011

NPI assigned

Mar 20, 2021

Sex

Male

Sole proprietor

No

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.

• Mountain State Medical Specialties, PLLC

  • Dermatology Physician
  • Bridgeport, WV
  • NPI 1891892097

  Dermatology, WV

  Medicare reassignment Care Compare group NPD

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

• Reynolds Memorial Hospital, Inc

  • General Acute Care Hospital
  • Glen Dale, WV
  • NPI 1144228305

  Hospital

  Care Compare affiliation
• Wheeling Hospital Inc

  • General Acute Care Hospital
  • Wheeling, WV
  • NPI 1104821305

  Hospital

  Care Compare affiliation

Specialty

Dermatology

Education

West Virginia University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain State Medical Specialties PLLC 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
• Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jblee@msms.emadirect.md

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 2, 2025.

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1679159776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CABELA DR",
            "city": "TRIADELPHIA",
            "state": "WV",
            "postal_code": "260591044",
            "telephone_number": "681-618-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CABELA DR",
            "city": "TRIADELPHIA",
            "state": "WV",
            "postal_code": "260591044",
            "telephone_number": "681-618-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUSTIN",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-20",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WV",
            "license": "32512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Sue Haught, MS
• Jennifer Lynne Hornick, BA, BSW, LSW
• Jodi Lynn Irvin
• Benjamin Johnson, DPT
• Megan G Kurpil
• Kathleen Lichwa
• Tammy Lynn Lowe
• Dante Anthony Marra, MD
• Roger L Menard
• Lisa Miehle, PHARMD

• All providers in Triadelphia, WV
• Dermatology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.