Individual provider Active NPI

James Hyun Soo Lee, M.D.

  • Surgery Physician
  • Bremerton, WA
National Provider Identifier
1003163007
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD446455 Issued in PA
Practice address
CVN 76 Uss Ronald Reagan
Bremerton, WA 98310
Phone
(610) 304-4921
NPI assigned
Aug 8, 2012
Last updated
Aug 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD446455 PA Primary

Addresses

Primary practice location

CVN 76 Uss Ronald Reagan
Bremerton, WA 98310

Mailing address

1105 Washington St
Apartment 1a
Hoboken, NJ 07030-5382
Phone (610) 304-4921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161020000626 NJ Practitioner - General Surgery 6406086917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abc Surgical Associates LLCGroup PAC ID 7719168954, 2 clinicians

Practice addresses (Care Compare)

5 Franklin Ave
Suite 406
Belleville, NJ 07109-3504
Phone (973) 759-4490

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD446455PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Surgical Associates LLC Surgery CurrentSince Sep 20, 2016 Accepting new patients
Amirata Surgical Associates Surgery CurrentSince Sep 20, 2016 Accepting new patients

Locations

5 Franklin Ave
Ste 406
Belleville, NJ 07109
Phone (973) 759-4490

Interoperability endpoints

  • Direct secure messaging: jlee249936@epicdirect.rwjbh.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1003163007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 WASHINGTON ST",
            "address_2": "APARTMENT 1A",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305382",
            "telephone_number": "610-304-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CVN 76 USS RONALD REAGAN",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98310",
            "telephone_number": "610-304-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAMES",
        "middle_name": "HYUN SOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD446455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.