Active NPI
John Lee, PA
- Medical Physician Assistant
- Bronx, NY
National Provider Identifier
1043397680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 363AMO700X
- Practice address
- 1276 Fulton Ave
Psychiatry - MMTP
Bronx, NY 10456-3402 - Phone
- (718) 503-7794
- Fax
- (718) 503-7751
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 363AMO700X | NY | Primary |
Addresses
Primary practice location
1276 Fulton Ave
Psychiatry - MMTP
Bronx, NY 10456-3402
Mailing address
5836 Fieldston Rd
Private House
Bronx, NY 10471-2212
Phone (718) 601-3192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 363AMO700X | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043397680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5836 FIELDSTON RD",
"address_2": "PRIVATE HOUSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104712212",
"telephone_number": "718-601-3192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1276 FULTON AVE",
"address_2": "PSYCHIATRY - MMTP",
"city": "BRONX",
"state": "NY",
"postal_code": "104563402",
"telephone_number": "718-503-7794",
"fax_number": "718-503-7751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "363AMO700X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.