Su Jung Lee
Individual provider Active NPI Family Nurse Practitioner · New York, NY
NPI 1295201036 · NPPES record last updated Jun 8, 2026
Key facts
- NPI
- 1295201036
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F339256 (NY)
- Practice address
- 1468 Madison Ave
New York, NY 10029-6508 - Phone
- (212) 241-6500
- NPI assigned
- Oct 19, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aleracare Medical Group of California
Practice addresses (Care Compare)
2510 Webster St
Berkeley, CA 94705-2557
Phone (888) 209-8874
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220621002420 | CA | Practitioner - Nurse Practitioner | 4981083011 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F339256 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aleracare Medical Group of California, a Medical Corporation | Current |
Accepting new patients | |
| Pure Healthcare Professional Medical Services | Current |
Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Current |
Accepting new patients | |
| Aleracare Medical Group of California | Current | Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Past | Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Past | Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Past | Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Past | Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Past | Accepting new patients | |
| Aleracare Medical Group of California, a Medical Corporation | Past | Accepting new patients |
Locations
2915 Telegraph Ave
Ste 304
Berkeley, CA 94705
Phone (510) 843-4077
2510 Webster St
Berkeley, CA 94705
Phone (510) 548-6555
150 N Robertson Blvd
Ste 206
Beverly Hills, CA 90211
Phone (310) 407-0542
39243 Liberty St
Fremont, CA 94538
Phone (510) 279-9088
660 W Locust Ave
Ste 103
Fresno, CA 93650
Phone (559) 500-0910
435 Arden Ave
Ste 460
Glendale, CA 91203
Phone (818) 243-1187
1580 W El Camino Real
Ste 5
Mountain View, CA 94040
151 N Sunrise Ave
Ste 1203
Roseville, CA 95661
Phone (916) 771-3800
2331 Montpelier Dr
Ste 20
San Jose, CA 95116
Phone (847) 942-8586
2001 Santa Monica Blvd
Ste 1160W
Santa Monica, CA 90404
Phone (310) 828-2042
2650 Jones Way
Ste 30
Simi Valley, CA 93065
Phone (805) 267-6161
2321 W March Ln
Ste 100
Stockton, CA 95207
Phone (209) 921-3895
7039 Valjean Ave
#A
Van Nuys, CA 91406
Phone (602) 404-0015
4849 Van Nuys Blvd
Ste 211
Van Nuys, CA 91403
Phone (818) 788-8210
4179 S Riverboat Rd
Ste 220
Taylorsville, UT 84123
Phone (801) 590-9267
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F339256 | NY | Yes |
Addresses
Primary practice location
1468 Madison Ave
New York, NY 10029-6508
Mailing address
1468 Madison Ave
New York, NY 10029-6508
Phone (212) 241-6500
Other practice location 1
2331A Montpelier Dr Ste 20
San Jose, CA 95116-1614
Phone (408) 647-1524
Other practice location 2
2001 Santa Monica Blvd Ste 1160W
Santa Monica, CA 90404-2120
Phone (424) 282-6574
Other practice location 3
4849 Van Nuys Blvd Ste 211
Sherman Oaks, CA 91403-2127
Phone (747) 262-5075
Other practice location 4
2510 Webster St
Berkeley, CA 94705-2557
Phone (562) 625-0819
Other practice location 5
1580 W El Camino Real Ste 5
Mountain View, CA 94040-2461
Phone (650) 623-5731
Other practice location 6
2915 Telegraph Ave Ste 304
Berkeley, CA 94705-2030
Phone (562) 625-0819
Other practice location 7
435 Arden Ave Ste 460
Glendale, CA 91203-1139
Phone (747) 330-4769
Other practice location 8
2321 W March Ln Ste 100
Stockton, CA 95207-5278
Phone (209) 921-3895
Other practice location 9
151 N Sunrise Ave Ste 1203
Roseville, CA 95661-2932
Phone (916) 850-2559
Other practice location 10
660 W Locust Ave Ste 103
Fresno, CA 93650-1094
Phone (559) 500-0910
Other practice location 11
150 N Robertson Blvd Ste 206
Beverly Hills, CA 90211-2144
Phone (424) 550-3478
Other providers in New York, NY
- Steve Young Lee
- Steven Lee
- Steven Lee
- Steven Joesph Lee
- Steven S Lee
- Su-Jung Lee
- Suah Lee
- Subin Lee
- Sue Ling Lee
- Sue Sueryun Lee
All providers in New York, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.