Active NPI
Young Soo Lee, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- New York, NY
National Provider Identifier
1073980744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 174894
- Practice address
- 211 E 13TH St
4E
New York, NY 10003-5691 - Phone
- (646) 919-2819
- NPI assigned
- Aug 28, 2015
- 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 |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 174894 | NY | Primary |
Addresses
Primary practice location
211 E 13TH St
4E
New York, NY 10003-5691
Mailing address
211 E 13TH St
4E
New York, NY 10003-5691
Phone (646) 919-2819
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 174894 | Other | NY | NEW YORK STATE LICENSE NUMBER |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174894 | NY | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1073980744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E 13TH ST",
"address_2": "4E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100035691",
"telephone_number": "646-919-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E 13TH ST",
"address_2": "4E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100035691",
"telephone_number": "646-919-2819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "YOUNG",
"middle_name": "SOO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-28",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NY",
"license": "174894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE LICENSE NUMBER",
"identifier": "174894",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.