Theodore Mark Lee, MD

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

024014 Issued in GA

Practice address

1800 Peachtree St. NW
Suite 720
Atlanta, GA 30309-2511

Phone

(404) 351-7520

Fax

(404) 355-2048

NPI assigned

Jul 7, 2006

Last updated

Apr 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in GA

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

Allergy/Immunology

Education

Northwestern University Feinberg Medical School, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Peachtree Allergy and Asthma Clinic PCGroup PAC ID 2264458132, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peachtree Allergy and Asthma Clinic PC

  • Allergy Physician
  • Atlanta, GA
  • NPI 1811035652
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1689606881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PEACHTREE ST. NW",
            "address_2": "SUITE 720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092511",
            "telephone_number": "404-351-7520",
            "fax_number": "404-355-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PEACHTREE ST. NW",
            "address_2": "SUITE 720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092511",
            "telephone_number": "404-351-7520",
            "fax_number": "404-355-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "THEODORE",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "GA",
            "license": "024014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2754388008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER POS",
            "identifier": "8791",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "480827",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00162933",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICADE",
            "identifier": "00278649K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00278649H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0481981",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven R. Lee, M. D.
• Susan Hae Kyung Lee, DMD
• Susan McManus Lee, PH.D.
• Sylvester Jerome Lee
• Tai-Lin Lee
• Tiah Shontaye Lee, RN
• Tiffany Alexandria Lee, MD
• Timothy K Lee
• Victoria Nogueira Lee, MSOTL
• Vivie Shang Lee, PA-C

• Allergy Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Allergy Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.