Active NPI
Richard Jin Lee, DPT
- Physical Therapist
- Manorville, NY
National Provider Identifier
1184165128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 041351
- Practice address
- 312 Weeks Ave
Manorville, NY 11949-2045 - Phone
- (631) 902-8230
- NPI assigned
- Mar 9, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 041351 | NY | Primary |
Addresses
Primary practice location
312 Weeks Ave
Manorville, NY 11949-2045
Mailing address
312 Weeks Ave
Manorville, NY 11949-2045
Phone (631) 902-8230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041351 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Medical Health PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Physician
- Spring Valley, NY
- NPI 1295043099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1184165128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 WEEKS AVE",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492045",
"telephone_number": "631-902-8230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 WEEKS AVE",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492045",
"telephone_number": "631-902-8230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "RICHARD",
"middle_name": "JIN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-09",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "041351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manorville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.