NPIMap

Individual provider Active NPI

Jay Yung Lee, M.D

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1417984097
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
175198 Issued in NY
Practice address
1000 10TH Avenue
New York, NY 10019
Phone
(212) 590-2930
Fax
(212) 590-2982
NPI assigned
Jun 27, 2006
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35.140765 OH
Diagnostic Radiology Physician 2085R0202X 175198 NY Primary
Radiological Physics Physician 2085R0205X 175198 NY

Addresses

Primary practice location

1000 10TH Avenue
New York, NY 10019

Mailing address

1780 Broadway
Suite 1100
New, NY 10019
Phone (212) 590-2930

Other identifiers 2

IdentifierTypeStateIssuer
02001307MedicaidNY
0421870MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, OH3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070416000365 NY Practitioner - Diagnostic Radiology 8022113349 Reassigns benefits to 1 organization
I20201023001993 NJ Practitioner - Diagnostic Radiology 8022113349 Reassigns benefits to 1 organization
I20210325001542 OH Practitioner - Diagnostic Radiology 8022113349

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

39 W Bayview Ave
Englewood Cliffs, NJ 07632-1402
Phone (888) 522-4514

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology CurrentSince Oct 1, 2015 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
West Side Radiology Associates, PC Diagnostic Radiology Past Accepting new patients
East Manhattan Diagnostic Imaging, P.C. Diagnostic Radiology Past Accepting new patients
Central Park Women Imaging Radiological Physics Past Accepting new patients

Locations

8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532

315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

Organizations & group practices 9

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 8

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1417984097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 BROADWAY",
            "address_2": "SUITE 1100",
            "city": "NEW",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-590-2930",
            "fax_number": "212-590-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-590-2930",
            "fax_number": "212-590-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAY",
        "middle_name": "YUNG",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.140765",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "175198",
            "primary": true
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "NY",
            "license": "175198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02001307",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0421870",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.