Jung Lack Lee, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

144342 Issued in NY

Practice address

143-25A Roosevelt Ave.
Flushing, NY 11354

Phone

(718) 353-0505

Fax

(718) 966-2576

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General SurgeryAlso: General Practice

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jll9018@direct.nyp.org

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.

• Joon J Bang, MD, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1134459407
  NPD (past)
• Parkside Medical Office, PLLC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1356657332
  NPD (past)
• University Group Medical Associates, P.C

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1285683102

  Surgery

  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1457394306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 POWELL ST.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10312",
            "telephone_number": "718-966-6000",
            "fax_number": "718-966-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143-25A ROOSEVELT AVE.",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-353-0505",
            "fax_number": "718-966-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUNG",
        "middle_name": "LACK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "144342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00823818",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joong Guk Lee
• Joungray Lee
• Julianne So Young Lee, M.D.
• Jun Lee, M.D
• Jun Lee, P.T
• Jungwon Lee, L.AC.
• Junho Bok Lee, MD
• Ka-Wing Lee
• Kai Yuen Peter Lee
• Katherine Lee, D.D.S.

• Surgery Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.