Individual provider Active NPI

Nathan David Lee, M.D.

  • Obstetrics & Gynecology Physician
  • Saint Cloud, MN
National Provider Identifier
1962677518
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
53937 Issued in MN
Practice address
251 County Road 120
Saint Cloud, MN 56303-4872
Phone
(320) 202-8949
Fax
(320) 202-0756
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 53937 MN Primary

Addresses

Primary practice location

251 County Road 120
Saint Cloud, MN 56303-4872

Mailing address

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Other identifiers 1

IdentifierTypeStateIssuer
1962677518MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20110725000410 MN Practitioner - Obstetrics/Gynecology 3870761570 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Centracare Clinic Current Accepting new patients
Unity Family Healthcare CurrentSince Jul 1, 2024 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Centracare Clinic CurrentSince Jun 1, 2016 Accepting new patients
Unity Family Healthcare CurrentSince Jul 1, 2024 Accepting new patients
Centracare Clinic CurrentSince Jun 1, 2016 Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

320 3rd Ave
Albany, MN 56307
Phone (320) 845-2157

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1301 33rd St S
Saint Cloud, MN 56301
Phone (320) 240-6955

251 County Road 120
Sartell, MN 56303
Phone (320) 202-8949

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: nlee298345@direct.centracare.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1962677518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 COUNTY ROAD 120",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034872",
            "telephone_number": "320-202-8949",
            "fax_number": "320-202-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "NATHAN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "53937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962677518",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.