Timothy Wong Sung Lee

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95023451 Issued in CA

Practice address

11448 Loma Linda Dr
Loma Linda, CA 92354-3744

Phone

(301) 821-3477

NPI assigned

Jun 16, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates Medical Group IncGroup PAC ID 5092604447, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: timothy.lee.1@19859.direct.athenahealth.com

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.

• Nephrology Associates Medical Group Inc

  • Nephrology Physician
  • Riverside, CA
  • NPI 1447200126
  Medicare reassignment Care Compare group NPD
• VHC, P.C.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1306582119
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1356026405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053071",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11448 LOMA LINDA DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543744",
            "telephone_number": "301-821-3477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Highland Ave Ste 551",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924043840",
            "country_code": "US",
            "telephone_number": "909-882-9150",
            "fax_number": "909-883-8972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "TIMOTHY",
        "middle_name": "WONG SUNG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-16",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sidney Renee Lee, MD
• Sonny C Lee, M.D.
• Stella Young Mi Lee
• Steve Lee, M.D.
• Tammie W Lee, PHARM.D.
• Tori Kealani Lee
• Tzu-Ying Lee, PHARMD
• Vallent Lee
• Victor Lee
• Kevin Leeper

• Family Nurse Practitioner in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.