Individual provider Active NPI

Julia Goon Lee, CPNP

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1043427503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
197007 Issued in MA
Practice address
750 Washington St
Boston, MA 02111-1526
Phone
(617) 636-5241
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 197007 MA Primary

Addresses

Primary practice location

750 Washington St
Boston, MA 02111-1526

Mailing address

27 Lagrange St
Chestnut Hill, MA 02467-3001

Other identifiers 1

IdentifierTypeStateIssuer
1213288MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080801000438 MA Practitioner - Nurse Practitioner 5496829848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
197007MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc CurrentSince Aug 15, 2011 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1
Boston, MA 02111

750 Washington St
Boston, MA 02111
Phone (617) 636-4600

800 Washington St
#7105
Boston, MA 02111
Phone (617) 636-2395

Interoperability endpoints

  • Direct secure messaging: jlee59857@tuftsmedicine.direct-ci.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043427503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 LAGRANGE ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111526",
            "telephone_number": "617-636-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JULIA",
        "middle_name": "GOON",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "197007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1213288",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.