Jay Won Lee, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A84879 Issued in CA

Practice address

1550 Superior Ave
Costa Mesa, CA 92627-3653

Phone

(949) 270-2100

Fax

(949) 650-4458

NPI assigned

Jun 9, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jay.lee.p1@direct.kcs.nextgenshare.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Share Our Selves Corporation

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1184279952

  Corporate Officer

  CMS ownership

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.

• Share Our Selves Corporation

  • Federally Qualified Health Center (FQHC)
  • Costa Mesa, CA
  • NPI 1508073685
  Medicare reassignment NPD
• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1831600634
  NPD
• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1861525602
  NPD
• Share Our Selves Corporation

  • Federally Qualified Health Center (FQHC)
  • Costa Mesa, CA
  • NPI 1144717778
  NPD
• Share Our Selves Corporation

  • Federally Qualified Health Center (FQHC)
  • Mission Viejo, CA
  • NPI 1629494398
  NPD
• Share Our Selves Corporation

  • Federally Qualified Health Center (FQHC)
  • Costa Mesa, CA
  • NPI 1669258612
  NPD

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1548201726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10159",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926270050",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 SUPERIOR AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273653",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAY",
        "middle_name": "WON",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A84879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dani Lee
• Darlene Lee, ND
• Edward Lee, MD
• Ethan Lee
• James K Lee, PT
• Justin Lee
• Justin Daniel Lee
• Kazjana Neura Lee
• Laura Ann Lee
• Lisa J Lee, M.A.

• Family Medicine Physician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.