Susie Kim Lee, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

207553 Issued in NY

Practice address

4422 3Rd Ave
Department of Medicine
Bronx, NY 10457-2545

Phone

(718) 960-6205

Fax

(718) 960-3218

NPI assigned

Oct 26, 2006

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• New York University

  dba NYU Faculty Group Practice

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  Internal Medicine, NY

  Medicare reassignment NPD
• New York University

  dba NYU Langone Ambulatory Care Chelsea

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613

  Internal Medicine

  NPD
• The Trustees of Columbia in the City of Ny Digestive and Liver Dise

  • Gastroenterology Physician
  • New York, NY
  • NPI 1306069315
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1730264797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-6205",
            "fax_number": "718-960-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSIE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "207553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02266824",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slee267135@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "355 W 52nd St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100196239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sun Y Lee, FNP
• Sung Ro Lee, MD
• Sunhee C Lee, MD
• Sur Lee, D.D.S.
• Susan Antonia Lee, RN
• Tae Kyung Lee, OTR/L
• Tal Avigal Lee, DO
• Tia Lee, MA
• Tracie S. Lee, PHD
• Vanessa Lee, MD

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.