Individual provider Active NPI

Mary Lee, MD

  • Allergy & Immunology Physician
  • New York, NY
National Provider Identifier
1962483685
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
177215 Issued in NY
Practice address
10 Union SQ E Ste 3F
Bimc Dept of Allergy
New York, NY 10003-3314
Phone
(212) 420-4013
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 177215 NY
Pediatrics Physician 208000000X 177215 NY
Allergy & Immunology Physician 207K00000X 177215 NY Primary

Addresses

Primary practice location

10 Union SQ E Ste 3F
Bimc Dept of Allergy
New York, NY 10003-3314

Mailing address

PO Box 32886
Hartford, CT 06150
Phone (212) 420-4013

Other identifiers 1

IdentifierTypeStateIssuer
01440904MedicaidNY

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
I20040821000185 NY Practitioner - Allergy/Immunology 0042284507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177215NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Allergy & Immunology CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Beth Israel Medical Center Allergy & Immunology Past Accepting new patients

Locations

948 48th St
Brooklyn, NY 11219
Phone (718) 283-7219

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

150 E 42nd St
#5
New York, NY 10017
Phone (212) 523-5898

10 Union Sq E
Ste 3F
New York, NY 10003
Phone (212) 420-4006

10 Union Sq E
#3
New York, NY 10003
Phone (212) 420-4145

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1962483685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32886",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06150",
            "telephone_number": "212-420-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E STE 3F",
            "address_2": "BIMC DEPT OF ALLERGY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-420-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "177215",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "177215",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "177215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01440904",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.