Active NPI
Jeffrey Lee, MD
- Psychiatry Physician
- Boulder, CO
National Provider Identifier
1316409709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DR.0068142
- Practice address
- 1942 Broadway Ste 314C
Boulder, CO 80302-5233 - Phone
- (970) 658-5206
- Fax
- (303) 502-8714
- NPI assigned
- Apr 3, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | DR.0068142 | CO | Primary |
Addresses
Primary practice location
1942 Broadway Ste 314C
Boulder, CO 80302-5233
Mailing address
1942 Broadway Ste 314C
Boulder, CO 80302-5233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2023 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1316409709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1942 BROADWAY STE 314C",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1942 BROADWAY STE 314C",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025233",
"telephone_number": "970-658-5206",
"fax_number": "303-502-8714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-03",
"last_updated": "2023-12-13",
"certification_date": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "DR.0068142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.