Jennifer Eun Joo Lee, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

20A17453 Issued in CA

Practice address

1147 Red Tail Way
Simi Valley, CA 93065-7232

Phone

(805) 527-8055

NPI assigned

Mar 18, 2015

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Eun Joo Lee Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Obstetrics/Gynecology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Simi Obstetrics and Gynecology Medical Group a Medical CorpGroup PAC ID 6305826561, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Simi Obstetrics & Gynecology Medical Group a Medical Corp.

  • Obstetrics & Gynecology Physician
  • Simi Valley, CA
  • NPI 1487858932
  Medicare reassignment Care Compare group NPD
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• Samir E. Hage, D.O., Inc.

  • Obstetrics & Gynecology Physician
  • Redlands, CA
  • NPI 1811184179
  NPD (past)

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

• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  Care Compare affiliation

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1033502869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 RED TAIL WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 RED TAIL WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657232",
            "telephone_number": "805-527-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIFER",
        "middle_name": "EUN JOO",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A17453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUN JOO",
            "last_name": "LEE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phillip Lavine, DC
• Sukhmani K Layal, M.D.
• Dong Quoc Le, O.D.
• Bennett Lee, M.D.
• Ga Yi Lee, M.D.
• Jennifer Nicole Lee, M.A., B.C.B.A.
• Kenon Lee
• Myungjae Lee, L.AC.
• Sang Jae Lee, LAC.
• Vernon Mark Lee, DMD

• Obstetrics & Gynecology Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.