Individual provider Active NPI

Diana Hwa-Jin Lee, M.D., PH.D

  • Pediatric Dermatology Physician
  • New York, NY
National Provider Identifier
1215105960
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
265073 Issued in NY
Practice address
1305 York Ave FL 9
New York, NY 10021-5663
Phone
(646) 962-3376
Fax
(646) 962-0033
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X 265073 NY Primary

Addresses

Primary practice location

1305 York Ave FL 9
New York, NY 10021-5663

Mailing address

1305 York Ave FL 9
New York, NY 10021-5663
Phone (646) 962-3376

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
I20131118000684 NY Practitioner - DermatologyPractitioner - Pediatric Medicine 2466688650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pediatric Medicine
Education
New York University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1305 York Ave
Suite 9
New York, NY 10021-5663
Phone (646) 962-3376

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
265073NYMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Pediatric Dermatology CurrentSince Jan 4, 2023 Accepting new patients
Weill Medical College of Cornell CurrentSince Jan 4, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Sep 19, 2013 Accepting new patients
Montefiore Medical Center CurrentSince Sep 19, 2013 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3514 Bainbridge Ave
Bronx, NY 10467
Phone (718) 920-2680

156 William St
Fl 11
New York, NY 10038
Phone (646) 962-3376

1305 York Ave
#9
New York, NY 10021
Phone (646) 962-3376

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

156 William St
New York, NY 10038
Phone (646) 962-4679

1305 York Ave
Fl 9
New York, NY 10021
Phone (646) 962-3376

211 E 80th St
Fl 2
New York, NY 10075
Phone (646) 962-8690

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1215105960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-3376",
            "fax_number": "646-962-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-3376",
            "fax_number": "646-962-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DIANA",
        "middle_name": "HWA-JIN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NY",
            "license": "265073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.