Individual provider Active NPI

Seong K. Lee, MD

  • Trauma Surgery Physician
  • Hollywood, FL
National Provider Identifier
1922021120
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
93917 Issued in FL
Practice address
1150 N 35TH Ave
Suite 135
Hollywood, FL 33021-5424
Phone
(954) 265-5969
Fax
(954) 965-3599
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 93917 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave
Suite 135
Hollywood, FL 33021-5424

Mailing address

1150 N 35TH Ave
Suite 135
Hollywood, FL 33021-5424
Phone (954) 265-5969

Other identifiers 2

IdentifierTypeStateIssuer
275990000MedicaidFL
93917OtherFLFLORIDA LIC#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20061013000036 FL Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 3577569698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1150 N 35TH Ave
Hollywood, FL 33021-5431

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9976

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93917FLMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 2, 2006 Accepting new patients
South Broward Hospital District Trauma Surgery CurrentSince Aug 2, 2006 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1150 N 35th Ave
Ste 135
Hollywood, FL 33021
Phone (954) 265-6989

1150 N 35th Ave
Ste 600
Hollywood, FL 33021
Phone (954) 265-5969

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: slee9514@mhsdirect.net

Organizations & group practices 4

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 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1922021120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 135",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-5969",
            "fax_number": "954-965-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 135",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-5969",
            "fax_number": "954-965-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEONG",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "93917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275990000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LIC#",
            "identifier": "93917",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.