Individual provider Active NPI

Ji Won Lee, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1194080473
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R193377 Issued in MD
Practice address
3333 N Calvert St Ste 400
Baltimore, MD 21218-6501
Phone
(410) 554-6890
Fax
(410) 554-6768
NPI assigned
Jul 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2013

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 R193377 MD Primary

Addresses

Primary practice location

3333 N Calvert St Ste 400
Baltimore, MD 21218-6501

Mailing address

3333 N Calvert St Ste 400
Baltimore, MD 21218-6501
Phone (410) 554-6890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20131105001122 MD Practitioner - Nurse Practitioner 3577798248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

3333 N Calvert St
Johnston Pro BLDG Suite 540
Baltimore, MD 21218-6502
Phone (410) 366-1438

Hospital & facility affiliations

  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
  • Medstar Union Memorial Hospital Hospital, Baltimore, MD, CCN 210024

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R193377MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 15, 2015 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 15, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3333 N Calvert St
Ste 540
Baltimore, MD 21218
Phone (410) 235-8858

3333 N Calvert St
Ste 400
Baltimore, MD 21218
Phone (410) 554-2270

12 Medstar Blvd
Ste 300
Bel Air, MD 21015
Phone (410) 296-6232

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

412 Malcolm Dr
Ste 200
Westminster, MD 21157
Phone (410) 751-7930

Organizations & group practices 3

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1194080473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N CALVERT ST STE 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212186501",
            "telephone_number": "410-554-6890",
            "fax_number": "410-554-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N CALVERT ST STE 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212186501",
            "telephone_number": "410-554-6890",
            "fax_number": "410-554-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JI WON",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R193377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.