Active NPI
Joseph Yae-Dam Lee, PA-C
- Physician Assistant
- Reston, VA
National Provider Identifier
1063379543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110011941
- Practice address
- 1830 Town Center Dr Ste 405
Reston, VA 20190-3218 - Phone
- (703) 481-9191
- NPI assigned
- Jan 7, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110011941 | VA | Primary |
Addresses
Primary practice location
1830 Town Center Dr Ste 405
Reston, VA 20190-3218
Mailing address
1830 Town Center Dr Ste 405
Reston, VA 20190-3218
Phone (703) 481-9191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110011941 | VA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779667200000",
"number": "1063379543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 TOWN CENTER DR STE 405",
"city": "RESTON",
"state": "VA",
"postal_code": "201903218",
"telephone_number": "703-481-9191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 TOWN CENTER DR STE 405",
"city": "RESTON",
"state": "VA",
"postal_code": "201903218",
"telephone_number": "703-481-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOSEPH",
"middle_name": "YAE-DAM",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-01-07",
"last_updated": "2026-05-25",
"certification_date": "2026-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110011941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.