Individual provider Active NPI

Benjamin J Lee, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1780912667
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704244930 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 788-4800
Fax
(517) 780-7352
NPI assigned
Dec 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704244930 MI
Certified Registered Nurse Anesthetist 367500000X 4704244930 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 788-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000808 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527103555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

1125 E Michigan Ave
Henry Ford Allegiance Surgery Center
Jackson, MI 49201-1801
Phone (517) 205-1080

205 N E Ave
Jackson, MI 49201-1753

205 S E Ave
Henry Ford Allegiance Digestive HLT
Jackson, MI 49201-2413
Phone (517) 205-2103

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Dec 31, 2009 Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince May 1, 2013 Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 31, 2009 Accepting new patients
Sjmhs Anesthesia Services Current Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince May 1, 2013 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: blee453112@direct.hfhs.org

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 and National Provider Directory roles.

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": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1780912667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4800",
            "fax_number": "517-780-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4800",
            "fax_number": "517-780-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704244930",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704244930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.