Individual provider Active NPI

Simon Lei

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1417722752
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407116 Issued in NY
Practice address
35 E 110TH St FL 4
New York, NY 10029-0354
Phone
(212) 360-7100
NPI assigned
Nov 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 907566 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407116 NY Primary

Addresses

Primary practice location

35 E 110TH St FL 4
New York, NY 10029-0354

Mailing address

35 E 110TH St FL 4
New York, NY 10029-0354
Phone (212) 360-7700

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250926001303 NY Practitioner - Nurse Practitioner 2365947645 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14428 Barclay Ave
Apt 5a
Flushing, NY 11355-1561

35 E 110TH St
FL 4
New York, NY 10029-0354
Phone (646) 322-5168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
907566NYMDRegistered Nurse
407116NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1417722752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E 110TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100290354",
            "telephone_number": "212-360-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E 110TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100290354",
            "telephone_number": "212-360-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEI",
        "first_name": "SIMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-16",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "907566",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.