Individual provider Active NPI

James M Lee Sr., MD

  • Specialist
  • West Orange, NJ
National Provider Identifier
1356373690
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA02744900 Issued in NJ
Practice address
81 Northfield Ave Ste 304
West Orange, NJ 07052-5344
Phone
(973) 672-2214
NPI assigned
Jul 7, 2006
Last updated
Jun 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA02744900 NJ Primary

Addresses

Primary practice location

81 Northfield Ave Ste 304
West Orange, NJ 07052-5344

Mailing address

81 Northfield Ave
Ste 304
West Orange, NJ 07052-5344
Phone (973) 672-2214

Other practice location 1

514 Joyce St
Orange, NJ 07050-1411
Phone (973) 672-2214

Other identifiers 1

IdentifierTypeStateIssuer
2896800MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090126000011 NJ Practitioner - Orthopedic Surgery 0244283026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA02744900NJMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1356373690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 NORTHFIELD AVE",
            "address_2": "STE 304",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525344",
            "telephone_number": "973-672-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 NORTHFIELD AVE STE 304",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525344",
            "telephone_number": "973-672-2214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Joyce St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "NJ",
            "postal_code": "070501411",
            "country_code": "US",
            "telephone_number": "973-672-2214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA02744900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2896800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.