Individual provider Active NPI

Joseph Lee, M.D., PH.D.

  • Radiation Oncology Physician
  • Bay Pines, FL
National Provider Identifier
1710153002
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0101254216 Issued in VA
Practice address
10000 Bay Pines Blvd Building 107
Bay Pines, FL 33744
Phone
(727) 398-6661
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 0101254216 VA Primary
Radiation Oncology Physician 2085R0001X 2009013733 MO

Addresses

Primary practice location

10000 Bay Pines Blvd Building 107
Bay Pines, FL 33744

Mailing address

10000 Bay Pines Blvd Building 107
Bay Pines, FL 33744
Phone (727) 398-6661

Other identifiers 1

IdentifierTypeStateIssuer
1710153002MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130716000014 DC Practitioner - Radiation Oncology 9931349982 Reassigns benefits to 1 organization
I20130819000486 VA Practitioner - Radiation Oncology 9931349982 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009013733MOMDRadiation Oncology Physician
0101254216VAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Oncology Associates, PC Radiation Oncology CurrentSince Jul 1, 2013 Accepting new patients
Radiation Oncology Specialists of Central Virginia PLC Radiation Oncology CurrentSince Aug 5, 2019 Accepting new patients
Mary Washington Hospital Inc. PastSince Aug 5, 2019 Accepting new patients

Locations

9568 Kings Charter Dr
Ste 202
Ashland, VA 23005
Phone (804) 266-8717

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

1300 Hospital Dr
Ste 101
Fredericksburg, VA 22401
Phone (540) 741-0655

2280 Opitz Blvd
Ste 120
Woodbridge, VA 22191
Phone (703) 580-5160

Interoperability endpoints

  • Direct secure messaging: jlee@mwhc.direct.varian.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1710153002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD BUILDING 107",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "33744",
            "telephone_number": "727-398-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD BUILDING 107",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "33744",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOSEPH",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2021-12-01",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101254216",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2009013733",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710153002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Pines, FL

Sources for this page

Verify at the official NPI Registry.