Individual provider Active NPI

Hye Sun Lee

  • Family Nurse Practitioner
  • Annandale, VA
National Provider Identifier
1164246013
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024190782 Issued in VA
Practice address
4208 Evergreen LN
Annandale, VA 22003-3235
Phone
(703) 642-2288
NPI assigned
Nov 7, 2024
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024190782 VA Primary

Addresses

Primary practice location

4208 Evergreen LN
Annandale, VA 22003-3235

Mailing address

4208 Evergreen LN
Annandale, VA 22003-3235
Phone (703) 642-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20251229002180 DC Practitioner - Nurse Practitioner 9739675893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10528 Reeds Landing Cir
Burke, VA 22015-2512

4208 Evergreen LN
Suite 222
Annandale, VA 22003-3251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024190782VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peter D Kim MD PC CurrentSince Dec 9, 2025 Accepting new patients
Virginia Open Senior Day Care LLC PastSince Oct 12, 2025 Accepting new patients

Locations

4208 Evergreen Ln
Ste 222
Annandale, VA 22003
Phone (703) 642-2288

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1164246013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033235",
            "telephone_number": "703-642-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033235",
            "telephone_number": "703-642-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HYE SUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024190782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.