Individual provider Active NPI

Russell D Lee, MD

  • Surgery Physician
  • Jamestown, NY
National Provider Identifier
1972573277
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
258146 Issued in NY
Practice address
15 S Main St
Suite 170
Jamestown, NY 14701-6626
Phone
(716) 483-1183
Fax
(716) 664-4903
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 258146 NY Primary

Addresses

Primary practice location

15 S Main St
Suite 170
Jamestown, NY 14701-6626

Mailing address

15 S Main St
Suite 300
Jamestown, NY 14701-6626
Phone (716) 483-1183

Other identifiers 2

IdentifierTypeStateIssuer
03338612MedicaidNY
J400168929OtherNYMEDICARE PTAN

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
I20110526000000 NY Practitioner - General Surgery 0547297202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers New Jersey Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medassist NJ IIGroup PAC ID 1557717428, 23 clinicians

Practice addresses (Care Compare)

Spring Valley, NY 10977
Phone (845) 377-6670

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medequipped LLC CurrentSince Jul 1, 2025 Accepting new patients
Medassist NJ II CurrentSince Jul 1, 2025 Accepting new patients
Great Lakes Physician Practice PC Surgery CurrentSince Jun 29, 2014 Accepting new patients
Genesis Health System Past Accepting new patients
Family Health Medical Services PLLC PastSince Sep 20, 2012 Accepting new patients
John Randolph Surgeons LLC Surgery Past Accepting new patients
Genesis Health System Past Accepting new patients
Culpeper Medical Associates, LLC Past Accepting new patients

Locations

15 S Main St
Ste 170
Jamestown, NY 14701
Phone (716) 483-1183

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

15 S Main St
Ste 300
Jamestown, NY 14701
Phone (716) 488-1877

747 Chestnut Ridge Rd
Ste 205
Spring Valley, NY 10977
Phone (845) 237-2381

2 Hot Metal St
Ste 1
Pittsburgh, PA 15203

Organizations & group practices 8

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1972573277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "address_2": "SUITE 300",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016626",
            "telephone_number": "716-483-1183",
            "fax_number": "716-664-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "address_2": "SUITE 170",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016626",
            "telephone_number": "716-483-1183",
            "fax_number": "716-664-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RUSSELL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "258146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03338612",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J400168929",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.