KEAT-JIN LEE (MD) – Otolaryngology Physician, NPI 1891716502

KEAT-JIN LEE (MD) is a healthcare provider. based in New haven, Connecticut. specializing in Otolaryngology Physician. They hold the professional credentials MD. They hold a License No. 015233 (CT). The NPI Number for KEAT-JIN LEE (MD) is 1891716502

Main info

Male
Name
KEAT-JIN LEE (MD)
NPI
1891716502
Phone
(203) 777-4005
Address
1 LONG WHARF DR
Enumeration Date
21 July 2006
Last Update Date
2 July 2009
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KEAT-JIN LEE (MD)

  • 1, Long Wharf Drive, Long Wharf, City Point, New Haven, New Haven County, Connecticut, 06519, United States

    SUITE 302

    NEW HAVEN, CT 065115991

    Phone: (203) 777-4005

    Fax: (203) 776-7741

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090715000523IOtolaryngologyCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06511)

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Reviews

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Frequently asked questions

How do payers reference KEAT-JIN LEE (MD)?
For KEAT-JIN LEE (MD), use NPI 1891716502 as the unique 10-digit identifier.
Is there an active status for KEAT-JIN LEE (MD)?
For scheduling context, KEAT-JIN LEE (MD) is shown as active in the registry.
How would a patient describe KEAT-JIN LEE (MD)'s focus?
For KEAT-JIN LEE (MD), the primary taxonomy reads as Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with KEAT-JIN LEE (MD)?
Directory geography for KEAT-JIN LEE (MD) centers on New Haven, Connecticut.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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