Individual provider Active NPI

Suyoun Lee, NP

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1295196756
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95001322 Issued in CA
Practice address
1245 Wilshire Blvd
Suite 703
Los Angeles, CA 90017-4810
Phone
(213) 977-0419
Fax
(213) 977-0225
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95001322 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd
Suite 703
Los Angeles, CA 90017-4810

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (213) 977-0419

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address suyoun.lee@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160906001287 CA Practitioner - Nurse Practitioner 1153617816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1808 Verdugo Blvd
Suite 208
Glendale, CA 91208-1415
Phone (818) 236-4540

500 N Garfield Ave
Monterey Park, CA 91754-1242
Phone (626) 307-6600

Hospital & facility affiliations

  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001322CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Health Physicians of Pih CurrentSince Apr 1, 2021 Accepting new patients
Pih Health Physicians Current Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jan 1, 2019 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jan 1, 2019 Accepting new patients
Pih Health Physicians CurrentSince Apr 1, 2021 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1245 Wilshire Blvd
Ste 703
Los Angeles, CA 90017
Phone (213) 977-0419

399 E Highland Ave
Ste 424
Sn Bernrdno, CA 92404
Phone (909) 833-5315

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1295196756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "213-977-0419",
            "fax_number": "213-977-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 703",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-977-0419",
            "fax_number": "213-977-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUYOUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95001322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "suyoun.lee@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1245 Wilshire Blvd",
            "address_2": "Suite 703",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900174810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.