NPIMap

Organization Active NPI

St Clair Orthopaedics and Sports Medicine PC

  • Orthopaedic Surgery Physician
  • Saint Clair Shores, MI
National Provider Identifier
1720041288
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ST CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC
Practice address
23829 Little Mack Ave Ste 100
Saint Clair Shores, MI 48080-1186
Phone
(586) 773-1300
NPI assigned
Apr 7, 2006
Last updated
Sep 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Dr. Christopher L Lee, MDNPI 1679536023
Title
President
Phone
(586) 416-1300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X MI Primary

Addresses

Primary practice location

23829 Little Mack Ave Ste 100
Saint Clair Shores, MI 48080-1186

Mailing address

22701 Hall Rd Ste 100
Macomb, MI 48042-5270
Phone (586) 416-4265

Other practice location 1

22701 Hall Rd Ste 100
Macomb, MI 48042-5270
Phone (586) 416-4265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040805000566 MI Part B Supplier - Clinic/Group Practice 4486625027 Receives reassigned benefits from 30 practitioners
Practice locations: Macomb, MI; Saint Clair Shores, MI
O20100930006500 MI DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4486625027 Practice locations: Macomb, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

22151 Moross Rd
Ste 212
Grosse Pointe, MI 48236
Phone (313) 343-7849

22701 Hall Rd
Macomb, MI 48042
Phone (586) 260-4665

22701 Hall Rd
Ste 200
Macomb, MI 48042

45555 Heydenreich Rd
Ste B
Macomb, MI 48044

23829 Little Mack Ave
Saint Clair Shores, MI 48080
Phone (586) 412-8757

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1720041288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22701 HALL RD STE 100",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480425270",
            "telephone_number": "586-416-4265",
            "fax_number": "586-416-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK AVE STE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801186",
            "telephone_number": "586-773-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22701 Hall Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480425270",
            "country_code": "US",
            "telephone_number": "586-416-4265",
            "fax_number": "586-416-0867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-416-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.