Individual provider Active NPI

Peter Jaehyung Lee, MD

  • Anesthesiology Physician
  • Southfield, MI
National Provider Identifier
1821078528
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301060430 Issued in MI
Practice address
16000 W 9 Mile Rd
Suite 601
Southfield, MI 48075-4808
Phone
(248) 849-8138
Fax
(248) 849-2069
NPI assigned
Jan 19, 2006
Last updated
Aug 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301060430 MI Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 4301060430 MI

Addresses

Primary practice location

16000 W 9 Mile Rd
Suite 601
Southfield, MI 48075-4808

Mailing address

16000 W 9 Mile Rd
Suite 601
Southfield, MI 48075-4808
Phone (248) 849-8138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20041013000280 MI Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 5496715641 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Critical Care (Intensivists)
Education
George Washington University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northland Anesthesia Associates PCGroup PAC ID 5294623336, 20 clinicians
Providence Park Anesthesia Associates, PCGroup PAC ID 7315009479, 19 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

30400 Telegraph Rd
Suite 405
Bingham Farms, MI 48025-5817
Phone (248) 849-8138

47601 Grand River Ave
Novi, MI 48374-1233
Phone (248) 465-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301060430MIMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Sleep & Pulmonary Medicine PLLC CurrentSince Feb 1, 2015 Accepting new patients
Providence Park Anesthesia Associates, PC Anesthesiology CurrentSince Sep 5, 2008 Accepting new patients
Michigan Pain Management Consultants-West, PC Anesthesiology PastSince Sep 12, 2007 Accepting new patients
Asadulla Mohammed MD PC PastSince Feb 1, 2015 Accepting new patients

Locations

30400 Telegraph Rd
Ste 405
Bingham Farms, MI 48025
Phone (248) 483-8138

29275 W 10 Mile Rd
Farmington Hills, MI 48336
Phone (248) 350-2722

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

Interoperability endpoints

  • Direct secure messaging: plee1135977@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1821078528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 W 9 MILE RD",
            "address_2": "SUITE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754808",
            "telephone_number": "248-849-8138",
            "fax_number": "248-849-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 W 9 MILE RD",
            "address_2": "SUITE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754808",
            "telephone_number": "248-849-8138",
            "fax_number": "248-849-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PETER",
        "middle_name": "JAEHYUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301060430",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MI",
            "license": "4301060430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.