NPIMap

Individual provider Active NPI

Bryan Michael Lee, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Greensburg, PA
National Provider Identifier
1710253554
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD456048 Issued in PA
Practice address
410 Pellis Rd Ste 2a
Greensburg, PA 15601-4700
Phone
(724) 689-1070
Fax
(724) 689-1063
NPI assigned
Mar 27, 2012
Last updated
Sep 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD456048 PA Primary

Addresses

Primary practice location

410 Pellis Rd Ste 2a
Greensburg, PA 15601-4700

Mailing address

410 Pellis Rd Ste 2a
Greensburg, PA 15601-4700
Phone (724) 689-1070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161017000490 PA Practitioner - Sports MedicinePractitioner - Family Practice 3274821731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Excela Health Dr
Latrobe, PA 15650-9001

410 Pellis Rd
Greensburg, PA 15601-4700

508 S Church St
Mount Pleasant, PA 15666-1702

508 S Church St (Frick Hospital Ca
Excela Health Obstetrics and Gynecology
Mount Pleasant, PA 15666-1702
Phone (724) 539-8581

532 W Pittsburgh St
Greensburg, PA 15601-2239

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD456048PAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc. CurrentSince Oct 1, 2016 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Oct 1, 2016 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Excela Health Physician Practices, Inc Past Accepting new patients

Locations

410 Pellis Rd
Ste 2A
Greensburg, PA 15601
Phone (724) 689-1070

530 South St
Ste 200
Greensburg, PA 15601
Phone (412) 832-7711

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

Interoperability endpoints

  • Direct secure messaging: bryanlee@emg.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1710253554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PELLIS RD STE 2A",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014700",
            "telephone_number": "724-689-1070",
            "fax_number": "724-689-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PELLIS RD STE 2A",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014700",
            "telephone_number": "724-689-1070",
            "fax_number": "724-689-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRYAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD456048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.