Individual provider Active NPI

Albert Ilsun Lee, MD

  • Anesthesiology Physician
  • Statesboro, GA
National Provider Identifier
1710947080
Registry record updated Jun 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
041454 Issued in GA
Practice address
1497 Fair Rd
Suite 206
Statesboro, GA 30458-0822
Phone
(912) 871-5951
Fax
(912) 871-2483
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 041454 GA Primary

Addresses

Primary practice location

1497 Fair Rd
Suite 206
Statesboro, GA 30458-0822

Mailing address

1499 Fair Rd
Statesboro, GA 30458-1683
Phone (912) 486-1482

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070523000052 GA Practitioner - AnesthesiologyPractitioner - Pain Management 4486638574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Southeast LLCGroup PAC ID 3870880792, 83 clinicians

Practice addresses (Care Compare)

1499 Fair Rd
Statesboro, GA 30458-1683
Phone (912) 486-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Anesthesia and Pain Managment Anesthesiology CurrentSince Apr 1, 2007 Accepting new patients
Ams Southeast LLC Anesthesiology CurrentSince Oct 15, 2017 Accepting new patients
Carolina Anesthesia Inc Anesthesiology Past Accepting new patients
Deercreek Anesthesia Consultants PLLC Anesthesiology Past Accepting new patients
Southeastern Anesthesia and Pain Management Group, PC Anesthesiology Past Accepting new patients

Locations

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

1497 Fair Rd
Ste 206
Statesboro, GA 30458
Phone (912) 486-1120

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 1

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466812800000",
    "number": "1710947080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581683",
            "telephone_number": "912-486-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD",
            "address_2": "SUITE 206",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580822",
            "telephone_number": "912-871-5951",
            "fax_number": "912-871-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ALBERT",
        "middle_name": "ILSUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "041454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.