Individual provider Active NPI

Kyung Min Lee, NP-C

  • Adult Health Nurse Practitioner
  • Pompton Plains, NJ
National Provider Identifier
1083904874
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00326000 Issued in NJ
Practice address
230 W Parkway
#10
Pompton Plains, NJ 07444-1060
Phone
(973) 835-0800
NPI assigned
Apr 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00326000 NJ Primary
Gerontology Nurse Practitioner 363LG0600X 26NJ00326000 NJ

Addresses

Primary practice location

230 W Parkway
#10
Pompton Plains, NJ 07444-1060

Mailing address

230 W Parkway
#10
Pompton Plains, NJ 07444-1060
Phone (973) 835-0800

Other names 1

  • Kyung-Min Lee Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110524000282 NJ Practitioner - Nurse Practitioner 3274719430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

1055 Hamburg Tpke
Wayne, NJ 07470-3235
Phone (973) 616-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Nov 1, 2014 Accepting new patients

Locations

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

1055 Hamburg Tpke
Ste 200
Wayne, NJ 07470
Phone (973) 248-1440

1055 Hamburg Tpke
Ste 300
Wayne, NJ 07470
Phone (973) 904-1177

Interoperability endpoints

  • Direct secure messaging: klee652277@nyumc.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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1083904874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W PARKWAY",
            "address_2": "#10",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441060",
            "telephone_number": "973-835-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W PARKWAY",
            "address_2": "#10",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441060",
            "telephone_number": "973-835-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KYUNG MIN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00326000",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00326000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYUNG-MIN",
            "last_name": "LEE",
            "credential": "NP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pompton Plains, NJ

Sources for this page

Verify at the official NPI Registry.