Individual provider Active NPI

Simone Lee, FNP-C

  • Family Nurse Practitioner
  • Binghamton, NY
National Provider Identifier
1194036475
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336391 Issued in NY
Practice address
161 Riverside Dr
Binghamton, NY 13905-4176
Phone
(607) 770-7074
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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 336391 NY Primary

Addresses

Primary practice location

161 Riverside Dr
Binghamton, NY 13905-4176

Mailing address

346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 797-4496

Other identifiers 1

IdentifierTypeStateIssuer
03395324MedicaidNY

Other names 1

  • Simone Bordenet Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000085 NY Practitioner - Nurse Practitioner 1153597703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
336391NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Mar 1, 2024 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Mar 1, 2024 Accepting new patients
United Medical Associates PC Past Accepting new patients

Locations

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

161 Riverside Dr
Binghamton, NY 13905
Phone (607) 760-7664

161 Riverside Dr
Ste 109
Binghamton, NY 13905
Phone (607) 770-7074

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

4417 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 729-2144

Interoperability endpoints

  • Direct secure messaging: slee196743@direct-guthrie.org

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 2

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1194036475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-797-4496",
            "fax_number": "607-729-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-770-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SIMONE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03395324",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIMONE",
            "last_name": "BORDENET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.