DR. LEE G THEOPHELIS MD
NPI 1861448318
Surgery - Plastic and Reconstructive Surgery in Melbourne, FL

Q: What is Lee Theophelis's NPI number?

The NPI number for Lee Theophelis is 1861448318. It was assigned to this individual provider in the NPPES registry on May 26, 2006.

Q: What is Lee Theophelis's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Q: When was this NPI record last updated?

The NPPES record for Lee Theophelis was last updated on November 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2006PECOS EnrolledAccepts Medicare Assignment

85.38/100

CMS Quality Rating

1350 HICKORY ST, MELBOURNE, FL 32901(321) 434-1401(321) 434-1667 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 3, 2023, Mar 12, 2020, Oct 31, 2018 and 1 more (4 updates tracked since 2016).

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About Dr. Lee G Theophelis Md NPPES

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

DR. LEE G THEOPHELIS MD (NPI 1861448318) is an individual plastic and reconstructive surgery provider in Melbourne, Florida, licensed in Florida (ME59792) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Holmes Regional Medical Center, and is a graduate of University Of Miami, Lm Miller School Of Medicine (1986).

NPPES Registry Identity

NPI1861448318

Entity TypeIndividualMale

Primary Taxonomy2086S0122X

Provider Legal NameDR. LEE G THEOPHELISCredential: MD

Location Address1350 HICKORY STMelbourne, FL 32901-3224

Mailing Address3300 S Fiske BlvdRockledge, FL 32955-4306

Phone(321) 434-1401

Fax(321) 434-1667

Sole ProprietorYes

Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 1986

Enumeration DateMay 26, 2006

Last NPPES UpdateNovember 3, 20234 updates tracked since enumeration

NPPES CertifiedNovember 3, 2023

✔ NPI 1861448318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

License✔ Licensed in FL · ME59792

Definition

A surgeon who specializes in plastic and reconstructive surgery.

Also ListedSurgery · Trauma SurgeryTaxonomy 2086S0127X · License ME59792 (FL)

1350 HICKORY ST, Melbourne, FL 32901

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Other Identifiers 3

Other18869WFL · Fl Medicare

Other18869VFL · Fl Medicare

Medicaid372847100FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc..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

Dr. Lee G Theophelis Md 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 ID8224060181

PECOS Enrollment IDI20050831000648

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 8

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.

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.

63 services31 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

54 services40 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

37 services37 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

37 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

22 services22 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

17 services13 patients

Hospital Affiliations CMS Care Compare

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

Holmes Regional Medical Center

Acute Care Hospitals · Melbourne, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100019

Location1350 S Hickory StMelbourne, FL 32901 · Brevard County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.65

Promoting Interoperability

Improvement Activities

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.

TOMOR SEDALIU

Hospitalist