DR. JONATHAN C LEE M.D. NPI 1205190147

NPI Information

NPI: 1205190147
Provider Name: DR. JONATHAN C LEE, M.D.
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

Organization: SUMMIT RADIOLOGY PC

PECOS Registration: Yes

Address:
5001 US HIGHWAY 30 W STE D
FORT WAYNE, IN
ZIP 46818
Phone: (260) 432-1568
Get Directions

DR. Jonathan C Lee, M.D. is a vascular and interventional radiology radiology in Fort Wayne, IN with 12 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. DR. Jonathan C Lee, M.D. NPI is 1205190147. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2012

The provider's business location address is:

5001 US HIGHWAY 30 W STE D
FORT WAYNE, IN
ZIP 46818-701
Phone: (260) 432-1568
Fax: (260) 432-4969

The NPI 1205190147 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2012 and was last updated on 8/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	5118-850	WISCONSIN	No
2	2085R0202X	Radiology	Diagnostic Radiology	62743	WISCONSIN	No
3	2085R0204X	Radiology	Vascular & Interventional Radiology	62743	WISCONSIN	No
4	2085R0204X	Radiology	Vascular & Interventional Radiology	01073121A	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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