Individual provider Active NPI

Sang Il Lee, M.D.

  • Family Medicine Physician
  • Farmingdale, NY
National Provider Identifier
1972035103
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
306776 Issued in NY
Practice address
206 Fallwood Pkwy
Farmingdale, NY 11735-4929
Phone
(631) 667-0388
Fax
(631) 968-7705
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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 306776 NY Primary

Addresses

Primary practice location

206 Fallwood Pkwy
Farmingdale, NY 11735-4929

Mailing address

15 Clearmeadow LN
Woodbury, NY 11797-1115

Other practice location 1

847 N Broadway
Massapequa, NY 11758-2373
Phone (631) 667-0388

Other practice location 2

2280A N Ocean Ave
Farmingville, NY 11738-2911
Phone (631) 698-7828

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
I20201117001175 NY Practitioner - Family Practice 5799024410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Comprehensive Medical Care PLLCGroup PAC ID 3678731908, 41 clinicians

Practice addresses (Care Compare)

847 N Broadway
Massapequa, NY 11758-2373
Phone (631) 667-0388

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Comprehensive Medical Care PLLC CurrentSince Aug 30, 2025 Accepting new patients
Shahzad Iqbal Physician PLLC PastSince Aug 30, 2025 Accepting new patients

Locations

206 Fallwood Pkwy
Farmingdale, NY 11735
Phone (516) 248-1020

847 N Broadway
Massapequa, NY 11758
Phone (516) 798-0441

1231 Deer Park Ave
North Babylon, NY 11703
Phone 6316670388612

Interoperability endpoints

  • Direct secure messaging: sang.lee.p1@direct.saintjosephs.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDHCCD

Organizations & group practices 2

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1972035103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CLEARMEADOW LN",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 FALLWOOD PKWY",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354929",
            "telephone_number": "631-667-0388",
            "fax_number": "631-968-7705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "847 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117582373",
            "country_code": "US",
            "telephone_number": "631-667-0388",
            "fax_number": "631-968-7705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2280A N Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Farmingville",
            "state": "NY",
            "postal_code": "117382911",
            "country_code": "US",
            "telephone_number": "631-698-7828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANG IL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "306776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

Verify at the official NPI Registry.