Individual provider Active NPI

Jason Daniel Lee, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1407111339
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01075242A Issued in IN
Practice address
8150 Oaklandon Rd Ste 130
Indianapolis, IN 46236-9554
Phone
(317) 621-1111
Fax
(317) 621-1110
NPI assigned
Jul 6, 2012
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 01075242A IN Primary

Addresses

Primary practice location

8150 Oaklandon Rd Ste 130
Indianapolis, IN 46236-9554

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other practice location 1

1011 Main St Ste 140
Indianapolis, IN 46224-6980
Phone (317) 957-9000

Other identifiers 2

IdentifierTypeStateIssuer
P01512418OtherINMEDICARE RR PTAN
201311770MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlee164488@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150706001246 IN Practitioner - Family Practice 4789996794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8150 Oaklandon Rd
Suite 130
Indianapolis, IN 46236-9554
Phone (317) 621-1111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Jul 20, 2015 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 20, 2015 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1426 Broad Ripple Ave
Ste 200
Indianapolis, IN 46220
Phone (317) 621-3680

8150 Oaklandon Rd
Ste 130
Indianapolis, IN 46236
Phone (317) 621-1111

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

1011 Main St
Ste 140
Speedway, IN 46224
Phone (317) 328-0901

Interoperability endpoints

  • Direct secure messaging: jlee164488@ecommunitydirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1407111339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 OAKLANDON RD STE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462369554",
            "telephone_number": "317-621-1111",
            "fax_number": "317-621-1110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Main St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462246980",
            "country_code": "US",
            "telephone_number": "317-957-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01075242A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PTAN",
            "identifier": "P01512418",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201311770",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlee164488@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8150 Oaklandon Rd Ste 130",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462369554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.