Individual provider Active NPI

Kim J. Lee, M.D.

  • Pediatric Cardiology Physician
  • Grand Rapids, MI
National Provider Identifier
1861587602
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
4301058639 Issued in MI
Practice address
25 Michigan St NE
Suite 4300
Grand Rapids, MI 49503
Phone
(616) 267-9150
Fax
(616) 267-1408
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 4301058639 MI Primary

Addresses

Primary practice location

25 Michigan St NE
Suite 4300
Grand Rapids, MI 49503

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

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
I20050721000138 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6305872631 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Reaver School Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan NE
Mc845
Grand Rapids, MI 49503-2560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301058639MIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Hospitals Pediatric Cardiology CurrentSince Oct 31, 2016 Accepting new patients
Spectrum Health Hospitals CurrentSince Oct 31, 2016 Accepting new patients
Munson Medical Center CurrentSince Jun 21, 2014 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2010 Accepting new patients
Spectrum Health Primary Care Partners Pediatric Cardiology CurrentSince Jul 1, 2010 Accepting new patients
Munson Medical Center CurrentSince Jun 21, 2014 Accepting new patients
Munson Medical Center Current Accepting new patients
Pennock Hospital Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

1000 East Paris Ave SE
Ste 246
Grand Rapids, MI 49546
Phone (616) 391-3304

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

25 Michigan St NE
Ste 4300
Grand Rapids, MI 49503
Phone (616) 267-9150

100 Michigan St NE
Fl 10
Grand Rapids, MI 49503
Phone (616) 267-1925

25 Michigan St NE
Ste 4200
Grand Rapids, MI 49503
Phone (616) 267-9150

330 Barclay Ave NE
Ste 201
Grand Rapids, MI 49503
Phone (616) 459-8247

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

588 E Lakewood Blvd
Fl 1
Holland, MI 49424
Phone (616) 494-5800

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

2009 Holton Rd
North Muskegon, MI 49445
Phone (231) 291-8020

225 N State St
Reed City, MI 49677
Phone (231) 832-7108

3950 Hollywood Rd
Ste 240
Saint Joseph, MI 49085
Phone (269) 408-1852

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Interoperability endpoints

  • Direct secure messaging: klee3484@epic00.corewelldirect.org
  • Direct secure messaging: kim.lee@epic00.shdirect.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1861587602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE",
            "address_2": "SUITE 4300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-267-9150",
            "fax_number": "616-267-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KIM",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301058639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.