Individual provider Active NPI

Nancy Jade Lee, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1124319991
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
274822 Issued in NY
Practice address
505 E 70TH St
New York, NY 10021-4872
Phone
(212) 746-3303
NPI assigned
Apr 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 274822 NY Primary

Addresses

Primary practice location

505 E 70TH St
New York, NY 10021-4872

Mailing address

PO Box 29751
New York, NY 10087-9751
Phone (646) 962-2494

Other practice location 1

3611 21st St
Long Island City, NY 11106-4705
Phone (718) 482-7772

Other practice location 2

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 518-5131

Other identifiers 1

IdentifierTypeStateIssuer
03923833MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521001824 NY Practitioner - Pediatric Medicine 9133449713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
274822NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Weill Medical College of Cornell CurrentSince Apr 1, 2019 Accepting new patients
Weill Medical College of Cornell Pediatrics CurrentSince Apr 1, 2019 Accepting new patients
Bronxcare Health System Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

3611 21st St
Long Island City, NY 11106
Phone (718) 482-7488

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

505 E 70th St
New York, NY 10021
Phone (212) 746-2900

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: njl4001@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1124319991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29751",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879751",
            "telephone_number": "646-962-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-746-3303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3611 21st St",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111064705",
            "country_code": "US",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-9648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577606",
            "country_code": "US",
            "telephone_number": "718-518-5131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "NANCY",
        "middle_name": "JADE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "274822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03923833",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.