Individual provider Active NPI

Justin Edward Lea, M.D.

  • Orthopaedic Surgery Physician
  • Perryburg, OH
National Provider Identifier
1760800759
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35.139456 Issued in OH
Practice address
1620 Brigham Dr.
#140
Perryburg, OH 43551
Phone
(419) 893-2455
Fax
(419) 891-6296
NPI assigned
Apr 7, 2014
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35.139456 OH Primary

Addresses

Primary practice location

1620 Brigham Dr.
#140
Perryburg, OH 43551

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531

Other identifiers 1

IdentifierTypeStateIssuer
0404515MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200619002473 OH Practitioner - Orthopedic Surgery 9032413539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

1601 Brigham Dr
Suite 200
Perrysburg, OH 43551-7117
Phone (419) 872-7700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement29
Lower limb (leg) arthroscopy (minimally invasive joint repair)12
Upper limb (arm) arthroscopy (minimally invasive joint repair)37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince May 1, 2023 Accepting new patients
Promedica Central Physicians Orthopaedic Surgery CurrentSince May 1, 2023 Accepting new patients

Locations

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

1601 Brigham Dr
Ste 200
Perrysburg, OH 43551
Phone (419) 872-7700

1620 Brigham Dr
Ste 140
Perrysburg, OH 43551
Phone (419) 893-2455

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Organizations & group practices 2

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 6

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1760800759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 BRIGHAM DR.",
            "address_2": "#140",
            "city": "PERRYBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "419-893-2455",
            "fax_number": "419-891-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEA",
        "first_name": "JUSTIN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.139456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0404515",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.