Dukyong Lee, DOCTORATE

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305212330 Issued in VA

Practice address

13504 Clear Lake CT
Herndon, VA 20171-3610

Phone

(703) 999-9371

NPI assigned

Feb 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jacob Lee Other name

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jackson Clinics Limited Partnership

  • Physical Therapist
  • Centreville, VA
  • NPI 1639594831

  DC

  Medicare reassignment NPD
• Probiomechanics LLC

  • Physical Therapist
  • Herndon, VA
  • NPI 1639887383

  DC

  Medicare reassignment NPD
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1528525433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13504 CLEAR LAKE CT",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201713610",
            "telephone_number": "703-999-9371",
            "fax_number": "844-296-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13504 CLEAR LAKE CT",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201713610",
            "telephone_number": "703-999-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DUKYONG",
        "name_prefix": "Dr.",
        "credential": "DOCTORATE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "LEE",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diana Laplante, COTA
• Kerrie Michelle Laughlin, CSAC, LPC
• Maureen E Leang, MA CCC-SLP
• Deborah I Leavens, MD
• Angelic Marie Lee, APRN
• Eunjoo Lee, BCBA
• Hon K. Lee, L.AC., DIPL.O.M.
• Kevin J Lee, MD
• Kyung Jae Lee, D.C
• Matthew Lee, D.C.

• Physical Therapist in Herndon, VA
• Providers in Herndon, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.