Individual provider Active NPI

Jeffrey P. Lee, MD

  • Diagnostic Radiology Physician
  • Kearney, NE
National Provider Identifier
1962480574
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
18472 Issued in NE
Practice address
5308 Parklane Drive
Suite 4B
Kearney, NE 68847-8629
Phone
(308) 865-2231
Fax
(308) 338-1671
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 18472 NE Primary

Addresses

Primary practice location

5308 Parklane Drive
Suite 4B
Kearney, NE 68847-8629

Mailing address

PO Box 2467
Kearney, NE 68848-2467
Phone (308) 865-2231

Other identifiers 1

IdentifierTypeStateIssuer
300019882OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080711000587 NE Practitioner - Diagnostic Radiology 9032166061 Reassigns benefits to 2 organizations
I20230127001339 KS Practitioner - Diagnostic Radiology 9032166061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plains Radiology Services LLCGroup PAC ID 1850453432, 61 clinicians

Practice addresses (Care Compare)

315 W 15TH St
Southwest Medical Center
Liberal, KS 67901-2455
Phone (620) 624-1651

Hospital & facility affiliations

  • Southwest Medical Center Hospital, Liberal, KS, CCN 170068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18472NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Island Radiology Associates PC Diagnostic Radiology CurrentSince Sep 9, 2019 Accepting new patients
Great Plains Radiology LLC Diagnostic Radiology PastSince May 16, 2021 Accepting new patients

Locations

3610 Richmond Cir
Ste 100
Grand Island, NE 68803
Phone (308) 382-6856

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

Organizations & group practices 3

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 1

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1962480574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2467",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688482467",
            "telephone_number": "308-865-2231",
            "fax_number": "308-338-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 PARKLANE DRIVE",
            "address_2": "SUITE 4B",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478629",
            "telephone_number": "308-865-2231",
            "fax_number": "308-338-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEFFREY",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "18472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300019882",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.