Kaileen Lee, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23677 Issued in MD

Practice address

9171 Baltimore National Pike
Suite 120
Ellicott City, MD 21042-3944

Phone

(410) 480-3705

Fax

(410) 480-3707

NPI assigned

Jul 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaileen.lee.1@8042.direct.athenahealth.com

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, MD

  Medicare reassignment Care Compare group
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1093251209
  NPD
• Life Fitness Physical Therapy LLC

  • Physical Therapist
  • Ellicott City, MD
  • NPI 1285882670
  NPD (past)

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1992083570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9194 RED BRANCH RD",
            "address_2": "STE J",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452005",
            "telephone_number": "240-640-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9171 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423944",
            "telephone_number": "410-480-3705",
            "fax_number": "410-480-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KAILEEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "25135",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Seungwon Lee
• Jee Eun Lee
• Jenna Lee
• Jisu Lee
• Jun Woo Lee, D.C.
• Philip Yukbong Lee, LAC, DAOM
• Rebecca Marie Lee, LCPC
• Susan C. Lee, M.D.
• Yat Tung Elise Lee
• Yohan Lee, D.C.

• Physical Therapist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.