LEE MICHAEL DE DORE PA
NPI 1790017085
Physician Assistant - Surgical in Winfield, IL

Q: What is Lee De Dore's NPI number?

The NPI number for Lee De Dore is 1790017085. It was assigned to this individual provider in the NPPES registry on February 11, 2010.

Q: What is Lee De Dore's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Lee De Dore was last updated on June 16, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 11, 2010PECOS EnrolledAccepts Medicare Assignment

25 N WINFIELD ROAD, SUITE 505, WINFIELD, IL 60190(630) 682-5653(630) 682-8946 Get Directions Write a Review

NPPES record last updated: June 16, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Lee Michael De Dore Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEE MICHAEL DE DORE PA (NPI 1790017085) is an individual surgical provider in Winfield, Illinois, licensed in Illinois (085003692) and active in the NPI registry since February 2010. He is enrolled in Medicare PECOS, is affiliated with Elmhurst Memorial Hospital, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1790017085

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameLEE MICHAEL DE DORECredential: PA

Location Address25 N WINFIELD ROAD, SUITE 505Winfield, IL 60190

Mailing Address1 Westbrook Corporate Ctr, Ste 240Westchester, IL 60154-5745 · (630) 682-5653 · Fax (630) 682-8946

Phone(630) 682-5653

Fax(630) 682-8946

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateFebruary 11, 2010

Last NPPES UpdateJune 16, 2017

✔ NPI 1790017085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in IL · 085003692

25 N WINFIELD ROAD, Winfield, IL 60190

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lee Michael De Dore Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193855161

PECOS Enrollment IDI20100617000810, I20150416002432

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

42 services38 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

20 services19 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

16 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Elmhurst Memorial Hospital

Acute Care Hospitals · Elmhurst, IL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number140200

Location155 East Brush Hill RoadElmhurst, IL 60126 · Du Page County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS A. EISEMAN M.D.

Emergency Medicine