Active NPI
Richard Joe Lee, DO
- Family Medicine Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 287169
- 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, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4846571 | Medicaid | NY |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 287169 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care for the Homeless | Multi-Specialty | Current | Accepting new patients |
| Care for the Homeless | Multi-Specialty | Current | Accepting new patients |
| Care for the Homeless | Current | Accepting new patients | |
| Care for the Homeless | Multi-Specialty | Past | 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
- 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.
-
dba Susan's Place Health Center
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1013154657
Multi-Specialty
-
dba Part of the Solution Health Center
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1891184750
Multi-Specialty
-
dba BLondell Avenue Health Center
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1952647430
-
dba Peter Jay Sharp Health Center
- Federally Qualified Health Center (FQHC)
- Brooklyn, NY
- NPI 1295071447
Multi-Specialty
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.