Individual provider Active NPI

Yun S. Lee, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Fort Lee, NJ
National Provider Identifier
1528603479
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309379-01 Issued in NY
Practice address
1590 Anderson Ave Apt 22a
Fort Lee, NJ 07024-2711
Phone
(201) 819-6178
NPI assigned
Nov 14, 2019
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309379-01 NY Primary

Addresses

Primary practice location

1590 Anderson Ave Apt 22a
Fort Lee, NJ 07024-2711

Mailing address

1590 Anderson Ave Apt 22a
Fort Lee, NJ 07024-2711
Phone (201) 819-6178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200120000064 NY Practitioner - Nurse Practitioner 2860827979 Reassigns benefits to 1 organization
I20220518001959 NJ Practitioner - Nurse Practitioner 2860827979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone (800) 825-5391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F309379-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SV Operating Three LLC CurrentSince Mar 18, 2020 Accepting new patients
Valley Physician Services PC CurrentSince Jun 1, 2022 Accepting new patients

Locations

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

91 Tompkins Ave
Staten Island, NY 10304
Phone (718) 876-1200

Interoperability endpoints

  • Direct secure messaging: yun.lee.1@5622.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1528603479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 ANDERSON AVE APT 22A",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242711",
            "telephone_number": "201-819-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 ANDERSON AVE APT 22A",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242711",
            "telephone_number": "201-819-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YUN",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309379-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.