Active NPI
Jong Y Lee, MD
- Anesthesiology Physician
- Miami, FL
National Provider Identifier
1063444271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ME89153
- Practice address
- 1611 NW 12TH Ave
Box 016960 (M851)
Miami, FL 33136-1005 - Phone
- (305) 243-6358
- Fax
- (305) 243-8470
- NPI assigned
- Jul 7, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ME89153 | FL | Primary |
| Anesthesiology Physician | 207L00000X | MD436059 | PA | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | MD436059 | PA |
Addresses
Primary practice location
1611 NW 12TH Ave
Box 016960 (M851)
Miami, FL 33136-1005
Mailing address
1611 NW 12TH Ave
Box 016960 (M851)
Miami, FL 33136-1005
Phone (305) 243-6358
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2698528-00 | Medicaid | PA | |
| 43304 | Other | PA | MEDICARE ID/UNSPECIFIED |
| 2698528-00 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD436059 | PA | MD | Critical Care Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1063444271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "BOX 016960 (M851)",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-243-6358",
"fax_number": "305-243-8470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "BOX 016960 (M851)",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-243-6358",
"fax_number": "305-243-8470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JONG",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME89153",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD436059",
"primary": false
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "PA",
"license": "MD436059",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2698528-00",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID/UNSPECIFIED",
"identifier": "43304",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2698528-00",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.