Individual provider Active NPI

Chung K Lee, MD

  • Therapeutic Radiology Physician
  • Minneapolis, MN
National Provider Identifier
1972609360
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
21846 Issued in MN
Practice address
Radiation Oncology Clinic
500 Harvard Street SE
Minneapolis, MN 55455
Phone
(612) 273-6700
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 71675 WI
Therapeutic Radiology Physician 2085R0203X 21846 MN Primary

Addresses

Primary practice location

Radiation Oncology Clinic
500 Harvard Street SE
Minneapolis, MN 55455

Mailing address

420 Delaware Street SE, MMC 292
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 273-6700

Other identifiers 2

IdentifierTypeStateIssuer
091512OtherMNFAIRVIEW
2T424LEOtherMNBLUE CROSS BLUE SHIELD

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address clee341959@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071214000053 MN Practitioner - Radiation Oncology 5193815108 Reassigns benefits to 8 organizations
I20191011002437 WI Practitioner - Radiation Oncology 5193815108 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 University Ave W
6TH Floor W
Saint Paul, MN 55104-3727
Phone (651) 232-2273

5160 Fairview Blvd
Suite 1200
Wyoming, MN 55092-8050
Phone (651) 982-3520

720 Washington Ave SE
Minneapolis, MN 55414-2924
Phone (612) 884-0649

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71675WIMDDiagnostic Radiology Physician
21846MNMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Feb 22, 2016 Accepting new patients
Fairview Clinics CurrentSince Jul 23, 2007 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 23, 2007 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 6, 2021 Accepting new patients
Avera Marshall CurrentSince May 23, 2022 Accepting new patients
Agnesian Healthcare Inc CurrentSince Sep 5, 2019 Accepting new patients
Avera Marshall Current Accepting new patients
Range Regional Health Services CurrentSince Jun 13, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Feb 22, 2016 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 6, 2021 Accepting new patients
Range Regional Health Services Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care Current Accepting new patients
Range Regional Health Services CurrentSince Jun 13, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Apr 1, 2003 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 6, 2021 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 6, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 28, 2023 Accepting new patients
Agnesian Healthcare Inc CurrentSince Sep 5, 2019 Accepting new patients
Avera Marshall CurrentSince May 23, 2022 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations (25 of 28)

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

420 Delaware St SE
#292
Minneapolis, MN 55455
Phone (612) 626-3345

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

1875 Woodwinds Dr
Ste WL30
Woodbury, MN 55125

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

2200 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4610

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

480 E Division St
Fond du Lac, WI 54935
Phone (800) 236-1428

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: clee418176@direct.centracare.com
  • Direct secure messaging: chung.lee@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 27

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.

View all 27

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1972609360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE, MMC 292",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RADIATION ONCOLOGY CLINIC",
            "address_2": "500 HARVARD STREET SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHUNG",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-11-17",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "71675",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "MN",
            "license": "21846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIRVIEW",
            "identifier": "091512",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2T424LE",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clee341959@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "clee341959@direct-ehr-ssmhc.com",
            "address_1": "480 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549353734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "480 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549353734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.