Individual provider Active NPI

Richard Joe Lee, DO

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1205245628
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
287169 Issued in NY
Practice address
89-111 Porter Avenue
Brooklyn, NY 11237
Phone
(347) 294-2435
Fax
(347) 294-2439
NPI assigned
Aug 11, 2014
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 287169 NY Primary

Addresses

Primary practice location

89-111 Porter Avenue
Brooklyn, NY 11237

Mailing address

30 E 33Rd St FL 5
New York, NY 10016-5337
Phone (212) 366-4459

Other identifiers 1

IdentifierTypeStateIssuer
4846571MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401000984 NY Practitioner - Family Practice 0840713764 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287169NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Care for the Homeless Multi-Specialty Current Accepting new patients
Care for the Homeless Multi-Specialty CurrentSince Jan 19, 2025 Accepting new patients
Care for the Homeless CurrentSince Jan 19, 2025 Accepting new patients
Care for the Homeless Multi-Specialty PastSince Jan 19, 2025 Accepting new patients

Locations

9023 161st St
Jamaica, NY 11432
Phone (718) 709-5054

30 E 33rd St
Fl 5
New York, NY 10016
Phone (212) 366-4459

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: richard.lee@cfth.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1205245628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 33RD ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165337",
            "telephone_number": "212-366-4459",
            "fax_number": "347-823-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89-111 PORTER AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11237",
            "telephone_number": "347-294-2435",
            "fax_number": "347-294-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RICHARD",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-11",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "287169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4846571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.