Individual provider Active NPI

Kevin Brian Lee, M.D.

  • Anesthesiology Physician
  • Stony Brook, NY
National Provider Identifier
1942568068
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
281395 Issued in NY
Practice address
100 Nicolls Rd
Health Sciences Center L4-060
Stony Brook, NY 11794
Phone
(631) 444-2078
Fax
(631) 638-1199
NPI assigned
Apr 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 281395 NY Primary

Addresses

Primary practice location

100 Nicolls Rd
Health Sciences Center L4-060
Stony Brook, NY 11794

Mailing address

100 Nicolls Rd
Health Sciences Center L4-060
Stony Brook, NY 11794
Phone (631) 444-2078

Other practice location 1

333 Route 25A
Suite 225
Rocky Point, NY 11778-8556
Phone (631) 744-3671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160609001842 NY Practitioner - Anesthesiology 3072803626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8480
Phone (631) 444-2975

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794-0001
Phone (631) 638-0800

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Anesthesiology CurrentSince Jan 30, 2023 Accepting new patients
Long Island Anesthesia Physicians LLP Anesthesiology CurrentSince Apr 1, 2016 Accepting new patients

Locations

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

333 Route 25A
Ste 225
Rocky Point, NY 11778
Phone (631) 503-1400

100 Nicolls Rd
#L4060
Stony Brook, NY 11794
Phone (631) 444-2078

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1942568068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD",
            "address_2": "HEALTH SCIENCES CENTER L4-060",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2078",
            "fax_number": "631-638-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD",
            "address_2": "HEALTH SCIENCES CENTER L4-060",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2078",
            "fax_number": "631-638-1199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Route 25A",
            "address_2": "Suite 225",
            "address_purpose": "LOCATION",
            "city": "Rocky Point",
            "state": "NY",
            "postal_code": "117788556",
            "country_code": "US",
            "telephone_number": "631-744-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KEVIN",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "281395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.