Individual provider Active NPI

Jennifer Paohung Lee, ANP-C

  • Nurse Practitioner
  • Stanford, CA
National Provider Identifier
1144565763
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95001363 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Dec 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 727859 CA
Critical Care Medicine Registered Nurse 163WC0200X 159080 NC
Adult Health Nurse Practitioner 363LA2200X 5006011 NC
Nurse Practitioner 363L00000X 95001363 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170728000058 CA Practitioner - Nurse Practitioner 4385882885 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
727859CAMDRegistered Nurse
159080NCMDCritical Care Medicine Registered Nurse
5006011NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jul 17, 2017 Accepting new patients
Stanford Health Care Current Accepting new patients
Stanford Health Care CurrentSince Jul 17, 2017 Accepting new patients

Locations

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: jlee197799@direct.stanfordhealthcare.org

Organizations & group practices 3

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": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144565763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIFER",
        "middle_name": "PAOHUNG",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "727859",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NC",
            "license": "159080",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5006011",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95001363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.