Individual provider Active NPI

Paul Yong Kyu Lee, MD

  • Internal Medicine Physician
  • Livingston, NJ
National Provider Identifier
1265019327
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12176900 Issued in NJ
Practice address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone
(732) 322-5000
NPI assigned
Mar 25, 2021
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA12176900 NJ Primary

Addresses

Primary practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Mailing address

185 S Orange Ave RM I-506
Newark, NJ 07103-2757
Phone (973) 972-4595

Other practice location 1

185 S Orange Ave Rm I-506
Newark, NJ 07103-2757
Phone (973) 972-4595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240726001114 NJ Practitioner - Internal Medicine 6800332719 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Emergency Medicine Associates, LLC Internal Medicine CurrentSince May 16, 2024 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Organizations & group practices 1

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1265019327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE RM I-506",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-4595",
            "fax_number": "973-972-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "732-322-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 S Orange Ave Rm I-506",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032757",
            "country_code": "US",
            "telephone_number": "973-972-4595",
            "fax_number": "973-972-5965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "PAUL",
        "middle_name": "YONG KYU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12176900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.