Individual provider Active NPI

Peter Lee, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1952372492
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9825 Issued in NV
Practice address
888 S Rancho Dr
Las Vegas, NV 89106-3810
Phone
(702) 750-3800
Fax
(702) 750-3808
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 9825 NV Primary

Addresses

Primary practice location

888 S Rancho Dr
Las Vegas, NV 89106-3810

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 838-8265

Other identifiers 3

IdentifierTypeStateIssuer
2018774MedicaidNV
3102774MedicaidNV
080173085OtherNVRAILROAD MEDICARE

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
I20040608000748 NV Practitioner - Family Practice 6800879214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

2716 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Jun 9, 2019 Accepting new patients
Southwest Medical Associates, Inc CurrentSince Jun 8, 2004 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 9, 2019 Accepting new patients
Linda L. Johnson MD, LTD Past Accepting new patients

Locations

300 E Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 435-4301

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

7061 Grand Montecito Pkwy
Las Vegas, NV 89149
Phone (702) 750-3800

Interoperability endpoints

  • Direct secure messaging: plee119447@westdirect.optum.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1952372492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-838-8265",
            "fax_number": "702-804-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063810",
            "telephone_number": "702-750-3800",
            "fax_number": "702-750-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "9825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018774",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102774",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080173085",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.