NPIMap

Individual provider Active NPI

Lee M Mitsumori, M.D.

  • Diagnostic Radiology Physician
  • Seattle, WA
National Provider Identifier
1972681336
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00041182 Issued in WA
Practice address
Radiology University of Washington Medical Ctr
1959 NE Pacific St
Seattle, WA 98195-0001
Phone
(206) 598-6200
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00041182 WA Primary

Addresses

Primary practice location

Radiology University of Washington Medical Ctr
1959 NE Pacific St
Seattle, WA 98195-0001

Mailing address

Radiology University of Washington Medical Ctr
1959 NE Pacific Street
Seattle, WA 98195-7115
Phone (206) 598-0024

Other identifiers 3

IdentifierTypeStateIssuer
0231575OtherWAL&I
4416OtherINTERNAL ID-MOTOR VEHICLE ID
1972681336MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028001133 HI Practitioner - Diagnostic Radiology 1052380664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Hawaii John a. Burns School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince Jul 7, 2024 Accepting new patients
The Association of University Physicians Diagnostic Radiology Current Accepting new patients
Kauai Medical Clinic CurrentSince Jul 7, 2024 Accepting new patients
Straub Clinic & Hospital CurrentSince Aug 31, 2013 Accepting new patients
Honolulu Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Straub Clinic & Hospital CurrentSince Aug 31, 2013 Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 6

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 4

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1972681336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RADIOLOGY UNIVERSITY OF WASHINGTON MEDICAL CTR",
            "address_2": "1959 NE PACIFIC STREET",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981957115",
            "telephone_number": "206-598-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RADIOLOGY UNIVERSITY OF WASHINGTON MEDICAL CTR",
            "address_2": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-598-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSUMORI",
        "first_name": "LEE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00041182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0231575",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "4416",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972681336",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.