Individual provider Active NPI

Winner Lee, D.O.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1831509637
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2529 Issued in NV
Practice address
2831 Business Park CT Ste 130a
Las Vegas, NV 89128-9007
Phone
(702) 844-4848
Fax
(702) 488-4849
NPI assigned
May 1, 2014
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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 DO2529 NV Primary

Addresses

Primary practice location

2831 Business Park CT Ste 130a
Las Vegas, NV 89128-9007

Mailing address

2370 Corporate Cir Ste 300
Henderson, NV 89074-7760
Phone (702) 910-3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20190709000683 NV Practitioner - Family Practice 1052638905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bacchus Wakefield Kahan PCGroup PAC ID 5991069643, 20 clinicians

Practice addresses (Care Compare)

2831 Business Park CT
Suite a
Las Vegas, NV 89128-9007
Phone (702) 844-4848

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bacchus PC Multi-Specialty CurrentSince Oct 18, 2021 Accepting new patients
P3 Health Partners Professional Services PC Multi-Specialty Past Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 239
Henderson, NV 89074
Phone (702) 844-4841

1500 W Sunset Rd
Ste 100120
Henderson, NV 89014
Phone (702) 888-3126

2370 Corporate Cir
Ste 300
Henderson, NV 89074
Phone (702) 910-3950

880 Seven Hills Dr
Ste 140
Henderson, NV 89052
Phone (702) 844-4840

2831 Business Park Ct
Ste A
Las Vegas, NV 89128
Phone (702) 844-4848

4275 Burnham Ave
Ste 320
Las Vegas, NV 89119
Phone (702) 735-8000

360 S Lola Ln
Bldg B
Pahrump, NV 89048
Phone (775) 505-0810

Interoperability endpoints

  • Direct secure messaging: wlee966834@oc.providencedirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1831509637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 CORPORATE CIR STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747760",
            "telephone_number": "702-910-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 BUSINESS PARK CT STE 130A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289007",
            "telephone_number": "702-844-4848",
            "fax_number": "702-488-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WINNER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.