NPIMap

Individual provider Active NPI

Jee Eun Lee

  • Nurse Practitioner
  • Reno, NV
National Provider Identifier
1336767417
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
831639 Issued in NV
Practice address
5590 Kietzke LN
Reno, NV 89511-3019
Phone
(775) 323-2080
Fax
(775) 325-2334
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 831639 NV Primary

Addresses

Primary practice location

5590 Kietzke LN
Reno, NV 89511-3019

Mailing address

5590 Kietzke LN
Reno, NV 89511-3019
Phone (775) 323-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200727001840 NV Practitioner - Nurse Practitioner 6305260175 Reassigns benefits to 1 organization
I20260625003659 HI Practitioner - Nurse Practitioner 6305260175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians
Sierra Neurosurgery GroupGroup PAC ID 3870588619, 24 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

440 E Golden Valley Rd
Reno, NV 89506-5722
Phone (775) 360-3000

5590 Kietzke LN
Reno, NV 89511-3019
Phone (775) 323-2080

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Neurosurgery Group CurrentSince Jul 1, 2020 Accepting new patients
Sierra Neurosurgery Group CurrentSince Jul 1, 2020 Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients

Locations

5590 Kietzke Ln
Reno, NV 89511
Phone (775) 323-2080

5070 Ion Dr
Ste 200
Sparks, NV 89436
Phone (775) 323-2080

Interoperability endpoints

  • Direct secure messaging: jee.lee.1@13729.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/13729/brand/6/csg/1/fhir/r4

Organizations & group practices 7

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 12

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1336767417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080",
            "fax_number": "775-325-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080",
            "fax_number": "775-325-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEE",
        "middle_name": "EUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "831639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.