Individual provider Active NPI

Jonathan Hongsupp Lee, MD

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1174617963
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A68174 Issued in CA
Practice address
899 Valencia St
San Francisco, CA 94110-1736
Phone
(415) 600-6960
Fax
(415) 369-1244
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A68174 CA Primary

Addresses

Primary practice location

899 Valencia St
San Francisco, CA 94110-1736

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (415) 600-6960

Other practice location 1

50 Mark West Springs Rd
Santa Rosa, CA 95403-1457
Phone (844) 987-6115

Other practice location 2

380 90th St
Daly City, CA 94015-1807
Phone (650) 301-8600

Other practice location 3

350 Rhode Island St Ste 200
San Francisco, CA 94103-5188
Phone (415) 826-7575

Other identifiers 1

IdentifierTypeStateIssuer
A68174OtherCASTATE MEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070604000756 CA Practitioner - Family Practice 1456459189 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1580 Valencia St
Suite 802
San Francisco, CA 94110-4415
Phone (415) 641-6566

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68174CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
County of San Mateo CurrentSince Jul 1, 2007 Accepting new patients
County of San Mateo CurrentSince Jul 1, 2007 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo Current Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Family Medicine Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations (25 of 33)

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

380 90th St
Daly City, CA 94015
Phone (650) 301-8600

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

1580 Valencia St
Fl 3
San Francisco, CA 94110

3838 California St
Rm 404
San Francisco, CA 94118
Phone (415) 600-0940

1580 Valencia St
Ste 802
San Francisco, CA 94110
Phone (415) 750-7050

899 Valencia St
Fl 1
San Francisco, CA 94110
Phone (415) 600-6960

240 King St
Ste G2
San Francisco, CA 94107
Phone (415) 600-2420

899 Valencia St
San Francisco, CA 94110
Phone (415) 600-6960

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

350 Rhode Island St
Ste 200
San Francisco, CA 94103
Phone (415) 600-6240

1375 Sutter St
Ste 308
San Francisco, CA 94109
Phone (415) 600-0140

2645 Ocean Ave
Lbby 3
San Francisco, CA 94132
Phone (415) 519-3079

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

Interoperability endpoints

  • Direct secure messaging: jlee51505@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1174617963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "415-600-6960",
            "fax_number": "415-369-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 VALENCIA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941101736",
            "telephone_number": "415-600-6960",
            "fax_number": "415-369-1244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Mark West Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031457",
            "country_code": "US",
            "telephone_number": "844-987-6115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 90th St",
            "address_purpose": "LOCATION",
            "city": "Daly City",
            "state": "CA",
            "postal_code": "940151807",
            "country_code": "US",
            "telephone_number": "650-301-8600",
            "fax_number": "650-301-8626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Rhode Island St Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941035188",
            "country_code": "US",
            "telephone_number": "415-826-7575",
            "fax_number": "415-369-1393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONATHAN",
        "middle_name": "HONGSUPP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A68174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A68174",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.