Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Seong Gon Bae, MD

Individual provider Surgery Physician · NPI 1114122769

Seong Gon Bae, MD is a General Surgery in Lake Mary, Florida. Graduated from University of South Florida College of Medicine in 2005, 21 years ago. Practices with Thomas J Lomis M D Inc a Professional Corporation, a 12-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California and Florida.

Years since qualifying
21
Trained at
University of South Florida College of Medicine
Licensed in
CA, FL
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4106 W Lake Mary Blvd Ste 330
Lake Mary, FL 32746-3383
Phone: (407) 833-9195
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15211 Vanowen St Unit 200, Van Nuys, CA 91405-3606 — (818) 782-3255

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence ME128524 (FL)
Surgery Physician Taxonomy 208600000X · Licence A123341 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1114122769
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 15, 2007
Last updated in NPPESFebruary 6, 2023
Certification dateFebruary 6, 2023
Mailing address4106 W Lake Mary Blvd Ste 330, Lake Mary, FL 32746-3383

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Thomas J Lomis M D Inc A Professional Corporation — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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