Individual provider Active NPI

Jong O. Lee, M.D.

  • Surgical Critical Care Physician
  • Galveston, TX
National Provider Identifier
1174631295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
L8107 Issued in TX
Practice address
815 Market St
Medical Staff Office
Galveston, TX 77550-2725
Phone
(409) 770-6731
Fax
(409) 770-6919
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X L8107 TX Primary

Addresses

Primary practice location

815 Market St
Medical Staff Office
Galveston, TX 77550-2725

Mailing address

815 Market St
Medical Staff Office
Galveston, TX 77550-2725
Phone (409) 770-6731

Other identifiers 1

IdentifierTypeStateIssuer
8718B7MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100212000048 TX Practitioner - General Surgery 0749323830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Oct 4, 2014 Accepting new patients
Utmb Faculty Group Practice CurrentSince Jul 1, 2002 Accepting new patients
Shriners Hospitals for Children CurrentSince Oct 4, 2014 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

1005 Harborside Dr
Fl 5
Galveston, TX 77555
Phone (409) 747-3376

815 Market St
Ofc
Galveston, TX 77550
Phone (409) 770-6731

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

Organizations & group practices 6

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 1

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174631295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 MARKET ST",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775502725",
            "telephone_number": "409-770-6731",
            "fax_number": "409-770-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MARKET ST",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775502725",
            "telephone_number": "409-770-6731",
            "fax_number": "409-770-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONG",
        "middle_name": "O.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "L8107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8718B7",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.