Individual provider Active NPI

Debora Lee, DO

  • Family Medicine Physician
  • Herkimer, NY
National Provider Identifier
1760472575
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
221374-1 Issued in NY
Practice address
321 E Albany St
Herkimer, NY 13350-2016
Phone
(315) 867-2700
Fax
(315) 867-2825
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 221374-1 NY Primary

Addresses

Primary practice location

321 E Albany St
Herkimer, NY 13350-2016

Mailing address

321 E Albany St
Herkimer, NY 13350-2016
Phone (315) 867-2700

Other identifiers 1

IdentifierTypeStateIssuer
02209781MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221374-1NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1760472575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E ALBANY ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502016",
            "telephone_number": "315-867-2700",
            "fax_number": "315-867-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E ALBANY ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502016",
            "telephone_number": "315-867-2700",
            "fax_number": "315-867-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DEBORA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "221374-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02209781",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Herkimer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.