Individual provider Active NPI

Jaeyoung Lee

  • Physical Therapist
  • Fresh Meadows, NY
National Provider Identifier
1396238523
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039869 Issued in NY
Practice address
7019 Parsons Blvd
Fresh Meadows, NY 11365-3049
Phone
(516) 203-8222
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 039869 NY Primary

Addresses

Primary practice location

7019 Parsons Blvd
Fresh Meadows, NY 11365-3049

Mailing address

7019 Parsons Blvd
Fresh Meadows, NY 11365-3049

Other practice location 1

6711 164th St
Fresh Meadows, NY 11365-3162
Phone (917) 293-8329

Other practice location 2

8829 Francis Lewis Blvd
Queens Village, NY 11427-2243
Phone (917) 293-8329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190812002471 NY Practitioner - Physical Therapist in Private Practice 6507192523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7019 Parsons Blvd
Fresh Meadows, NY 11365-3049
Phone (516) 203-8222

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039869NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jyl Physical Therapy PC Physical Therapist Current Accepting new patients
Cornerstone Occupational Therapy PC Physical Therapist CurrentSince May 11, 2025 Accepting new patients

Locations

7019 Parsons Blvd
Fresh Meadows, NY 11365
Phone (347) 822-1625

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1396238523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7019 PARSONS BLVD",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7019 PARSONS BLVD",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653049",
            "telephone_number": "516-203-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6711 164th St",
            "address_purpose": "LOCATION",
            "city": "Fresh Meadows",
            "state": "NY",
            "postal_code": "113653162",
            "country_code": "US",
            "telephone_number": "917-293-8329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8829 Francis Lewis Blvd",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114272243",
            "country_code": "US",
            "telephone_number": "917-293-8329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAEYOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.