Active NPI
Grace Sunah Lee, MD
- Pediatric Cardiology Physician
- Philadelphia, PA
National Provider Identifier
1851898720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- MT228198
- Practice address
- 3401 Civic Center Blvd Division of Pediatric Cardiology
Philadelphia, PA 19104 - Phone
- (267) 590-0427
- NPI assigned
- Apr 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | MT228198 | PA | Primary |
| Internal Medicine Physician | 207R00000X | 2022-01155 | NC | |
| Pediatrics Physician | 208000000X | 2022-01155 | NC | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3401 Civic Center Blvd Division of Pediatric Cardiology
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd Division of Pediatric Cardiology
Philadelphia, PA 19104
Phone (267) 590-0427
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022-01155 | NC | MD | Pediatrics Physician |
| MT228198 | PA | MD | Pediatric Cardiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1851898720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC CARDIOLOGY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "267-590-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC CARDIOLOGY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "267-590-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "GRACE",
"middle_name": "SUNAH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-09",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "PA",
"license": "MT228198",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "2022-01155",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2022-01155",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.