Individual provider Active NPI

Marc L Lee, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1962498709
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9792 Issued in AZ
Practice address
1010 E McDowell Rd Ste 300
Phoenix, AZ 85006-2609
Phone
(602) 251-3122
Fax
(602) 254-1226
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9792 AZ Primary

Addresses

Primary practice location

1010 E McDowell Rd Ste 300
Phoenix, AZ 85006-2609

Mailing address

1010 E McDowell Rd Ste 300
Phoenix, AZ 85006-2609
Phone (602) 251-3122

Other identifiers 2

IdentifierTypeStateIssuer
738514OtherHUMANA
AZ0883590OtherAZBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090126000439 AZ Practitioner - Internal Medicine 9931263696 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9792AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Nuclear Cardiology PLLC Current Accepting new patients
Summit Medical Group Arizona LLC Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Medical Specialists Past Accepting new patients

Locations

5620 W Thunderbird Rd
Ste F1
Glendale, AZ 85306
Phone (602) 938-6960

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

345 E Virginia Ave
Phoenix, AZ 85004
Phone (602) 254-3151

1301 E McDowell Rd
Ste 202
Phoenix, AZ 85006
Phone (602) 251-3122

1010 E McDowell Rd
Ste 300
Phoenix, AZ 85006
Phone (602) 251-3122

Interoperability endpoints

  • Direct secure messaging: marc.lee.1@19654.direct.athenahealth.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group Arizona LLC 152 clinicians

Practice addresses (Care Compare)

5620 W Thunderbird Rd
Suite F1
Glendale, AZ 85306-4652
Phone (888) 698-6727

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
  • Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1962498709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E MCDOWELL RD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062609",
            "telephone_number": "602-251-3122",
            "fax_number": "602-254-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E MCDOWELL RD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062609",
            "telephone_number": "602-251-3122",
            "fax_number": "602-254-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARC",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "9792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "738514",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0883590",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.