Individual provider Active NPI

Jung Sook Lee, MD

  • Family Medicine Physician
  • Columbia, PA
National Provider Identifier
1497774186
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD037840L Issued in PA
Practice address
1786C Columbia Ave
Columbia, PA 17512-9508
Phone
(717) 684-3663
Fax
(717) 684-9030
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD037840L PA Primary

Addresses

Primary practice location

1786C Columbia Ave
Columbia, PA 17512-9508

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Other practice location 1

937 May Rd
Lititz, PA 17543-7941
Phone (610) 780-3797

Other identifiers 1

IdentifierTypeStateIssuer
000654210MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070726000314 PA Practitioner - Family Practice 9436250008 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Family Medicine Current Accepting new patients
Pinnacle Health Medical Services Family Medicine CurrentSince Jan 14, 2020 Accepting new patients
Pinnacle Health Regional Physicians CurrentSince Nov 10, 2017 Accepting new patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince Nov 10, 2017 Accepting new patients
Washington Physician Services Family Medicine CurrentSince May 3, 2021 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jan 14, 2020 Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

366 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-1900

1786 Columbia Ave
#C
Columbia, PA 17512
Phone (717) 684-3663

1786C Columbia Ave
Columbia, PA 17512
Phone (717) 684-3663

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

1160 Manheim Pike
Lancaster, PA 17601
Phone (717) 397-7505

95 Leonard Ave
Bldg 2
Washington, PA 15301
Phone (724) 223-3100

190 N Main St
Ste 204
Washington, PA 15301
Phone (724) 223-9335

8012 Bretz Dr
West Hanover, PA 17112
Phone (717) 231-8320

Organizations & group practices 6

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1497774186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786C COLUMBIA AVE",
            "city": "COLUMBIA",
            "state": "PA",
            "postal_code": "175129508",
            "telephone_number": "717-684-3663",
            "fax_number": "717-684-9030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "937 May Rd",
            "address_purpose": "LOCATION",
            "city": "Lititz",
            "state": "PA",
            "postal_code": "175437941",
            "country_code": "US",
            "telephone_number": "610-780-3797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUNG",
        "middle_name": "SOOK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD037840L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000654210",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, PA

Sources for this page

Verify at the official NPI Registry.