Active NPI
Raymond Shang Joong Lee, D.O.
- Psychiatry Physician
- Melville, NY
National Provider Identifier
1154732592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 307208
- Practice address
- 59 Bushwick St
Melville, NY 11747-1201 - Phone
- (631) 943-5219
- NPI assigned
- May 19, 2014
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OT015955 | PA | |
| Psychiatry Physician | 2084P0800X | 21155 | NH | |
| Psychiatry Physician | 2084P0800X | OS018887 | PA | |
| Psychiatry Physician | 2084P0800X | 2018-00408 | NC | |
| Psychiatry Physician | 2084P0800X | 307208 | NY | Primary |
Addresses
Primary practice location
59 Bushwick St
Melville, NY 11747-1201
Mailing address
59 Bushwick St
Melville, NY 11747-1201
Phone (631) 943-5219
Other practice location 1
5515 Peach St
Erie, PA 16509-2603
Phone (814) 864-4031
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018-00408 | NC | MD | Psychiatry Physician |
| 21155 | NH | MD | Psychiatry Physician |
| OS018887 | PA | MD | Psychiatry Physician |
| OT015955 | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York City Health and Hospitals Corporation | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Current | Accepting new patients | |
| University Hospital at Stony Brook | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Current | Accepting new patients |
Locations
7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156
8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929
50 Water St
Fl 3
New York, NY 10004
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- raymond.lee@direct.stonybrookmedicine.edu
- rlee1600921@nychhc.direct-ci.com
Organizations & group practices 4
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.
-
- Clinic/Center
- New York, NY
- NPI 1548208127
-
- Clinic/Center
- Bronx, NY
- NPI 1003824608
-
- Clinic/Center
- New York, NY
- NPI 1538943469
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1154732592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 BUSHWICK ST",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117471201",
"telephone_number": "631-943-5219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 BUSHWICK ST",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117471201",
"telephone_number": "631-943-5219"
}
],
"practiceLocations": [
{
"address_1": "5515 Peach St",
"address_purpose": "LOCATION",
"city": "Erie",
"state": "PA",
"postal_code": "165092603",
"country_code": "US",
"telephone_number": "814-864-4031",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "RAYMOND",
"middle_name": "SHANG JOONG",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OT015955",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NH",
"license": "21155",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OS018887",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "2018-00408",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "307208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.