Active NPI 1861448318 Individual Practitioner Male Practitioner

Dr. Lee G Theophelis , MD

Surgery - Plastic and Reconstructive Surgery • Melbourne, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Lee Theophelis, MD is a certified Surgery - Plastic and Reconstructive Surgery practicing in Melbourne, FL. With approximately 40 years of clinical experience since graduating from University Of Miami, Lm Miller School Of Medicine in 1986, Dr. Theophelis delivers high-quality medical care to the local community at 1350 HICKORY ST.

Dr. Theophelis is affiliated with Health First Physician Specialties Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, follow-up hospital inpatient care per day. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1350 Hickory St

Melbourne, FL 329013224

Telephone 3214341401

Fax 3214341667

Associated Practice Facility / Clinic

🏢 Holmes Regional Medical Center, Inc. Facility NPI 1295702728

Medicare Profile & Education

Medical School

University Of Miami, Lm Miller School Of Medicine

Graduation Year

1986

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Melbourne, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

40 Yrs +12.5 yrs vs City Avg

City Avg: 27.5 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

10 Specialists

Practicing in Melbourne, FL (258 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

58.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Theophelis (40 Years) 40 Yrs

Melbourne Specialty Average (27.5 Years) 27.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	63	31	$180.00	$87.11
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	40	$114.07	$55.01
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$225.00	$107.14
99231 Follow-up hospital inpatient care per day, typically 15 minutes	37	17	$170.22	$48.69
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$334.00	$164.30
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	13	$486.00	$160.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$255.00	$125.08
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$369.53	$128.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	65	40	$191.49	$86.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	35	$121.63	$55.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	53	53	$225.53	$108.90
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$334.84	$164.21
99231 Follow-up hospital inpatient care per day, typically 15 minutes	30	12	$150.20	$47.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	16	$255.17	$125.19
99221 Initial hospital inpatient care per day, typically 30 minutes	16	16	$229.47	$78.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	60	34	$125.30	$56.06
99213 Established patient office or other outpatient visit, typically 15 minutes	55	28	$188.80	$90.42
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$338.00	$167.65
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$227.00	$112.38
99221 Initial hospital inpatient care per day, typically 30 minutes	25	24	$262.28	$101.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	19	$256.36	$127.00
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	20	13	$187.10	$71.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	71	27	$183.00	$92.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	67	67	$338.76	$168.88
99231 Follow-up hospital inpatient care per day, typically 15 minutes	35	11	$93.40	$38.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	32	21	$109.38	$56.23
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	28	11	$222.14	$72.50
99221 Initial hospital inpatient care per day, typically 30 minutes	27	25	$259.37	$103.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	27	22	$277.59	$125.90
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$226.00	$113.87
21011 Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp	16	16	$750.00	$283.84
11104 Punch biopsy, first skin growth	12	11	$257.00	$113.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	56	37	$92.59	$45.80
99202 New patient office or other outpatient visit, typically 20 minutes	42	42	$152.10	$74.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$216.30	$108.68
99221 Initial hospital inpatient care per day, typically 30 minutes	37	34	$237.11	$104.15
99231 Follow-up hospital inpatient care per day, typically 15 minutes	36	17	$100.00	$39.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	28	$224.13	$110.11
99213 Established patient office or other outpatient visit, typically 15 minutes	19	12	$149.84	$73.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	99	52	$149.00	$74.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	86	86	$219.00	$108.21
17250 Application of chemical to stop tissue regrowth in wound	34	13	$163.00	$76.21
99221 Initial hospital inpatient care per day, typically 30 minutes	29	29	$216.17	$104.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	25	$90.00	$44.94
99231 Follow-up hospital inpatient care per day, typically 15 minutes	19	12	$85.26	$40.20
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$154.00	$74.30
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	11	11	$1589.00	$793.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	89	46	$145.00	$72.26
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	46	23	$147.00	$71.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	41	41	$216.00	$107.63
99221 Initial hospital inpatient care per day, typically 30 minutes	38	36	$206.00	$102.82
99231 Follow-up hospital inpatient care per day, typically 15 minutes	35	22	$80.00	$39.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$330.00	$164.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	20	$214.00	$106.55
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	15	$87.00	$43.25
11100 Biopsy of single growth of skin and/or tissue	12	11	$211.00	$104.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	120	58	$146.97	$69.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	46	46	$218.07	$103.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	42	31	$215.98	$102.90
99221 Initial hospital inpatient care per day, typically 30 minutes	32	29	$222.00	$99.04
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	16	$88.00	$41.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$332.00	$158.16
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	12	12	$606.58	$210.81

Medical Specialties & State Licenses

CMS Verified: 2023-11-03

Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License FL ME59792

A surgeon who specializes in plastic and reconstructive surgery.

Surgery - Trauma Surgery

NUCC Taxonomy Code: 2086S0127X

State License FL ME59792

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

372847100 (FL)

Commercial Insurance / Payer ID Fl Medicare

18869W (FL)

Commercial Insurance / Payer ID Fl Medicare

18869V (FL)

Hospital & Practice Group Affiliations

Health First Physician Specialties Inc

1350 Hickory St, Melbourne, FL 329013224

Phone: 3214347000

Secondary Practice Locations

1223 Gateway Dr Ste 2b

Melbourne, FL 329012607

Phone: 3214341401

1350 Hickory St Ste 101

Melbourne, FL 329013224

Phone: 3214341401

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners

Dr. Brittany Warren , MD

Surgery - Trauma Surgery

NPI 1033556634

Doctor of Medicine (M.D.)

Dr. Kurt Hensel , MD

Orthopaedic Surgery

NPI 1073514337

Doctor of Medicine (M.D.)

Jonathan Huggins , PA-C

Physician Assistant

NPI 1083688626

Physician Assistant (Certified)

Meredith Thomas , PA-C

Physician Assistant - Surgical

NPI 1093888224

Physician Assistant (Certified)

Heather Scott , APRN

Nurse Practitioner - Adult Health

NPI 1154907822

Advanced Practice Registered Nurse

Jose Chavac Rodas

Nurse Practitioner - Acute Care

NPI 1174232896

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location November 03, 2023

Registered at 1350 HICKORY ST, MELBOURNE, FL 329013224 (Tel: 3214341401)

📍

Updated Practice Location March 12, 2020

Registered at 1350 HICKORY ST STE 101, MELBOURNE, FL 329013224 (Tel: 3214341401)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 12, 2020

Surgery (License #ME59792 in FL)

📍

Updated Business Mailing Address October 31, 2018

Registered at 3300 S FISKE BLVD, ROCKLEDGE, FL 329554306

✅

NPI Profile Active September 20, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location September 20, 2016

Registered at 1350 HICKORY ST, SUITE PSO, MELBOURNE, FL 329013224 (Tel: 3214341401)

📍

Updated Business Mailing Address September 20, 2016

Registered at 3466 N HARBOR CITY BLVD, MELBOURNE, FL 329355713 (Tel: 3214341982)

👤

Provider Name / Credentials Updated September 20, 2016

Recorded as LEE THEOPHELIS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2016

Surgery (License #ME59792 in FL)

🟢

Initial NPI Registration & Enumeration May 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861448318

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 26, 2006

Last Update: November 03, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

3300 S Fiske Blvd

Rockledge, FL 329554306

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.