Individual provider Active NPI

Hyunseok Lee, D.P.T

  • Physical Therapist
  • Fort Lee, NJ
National Provider Identifier
1548660582
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01566300 Issued in NJ
Practice address
810 Abbott Blvd
Ste 104
Fort Lee, NJ 07024-4116
Phone
(201) 514-1452
Fax
(201) 523-5423
NPI assigned
Aug 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01566300 NJ Primary

Addresses

Primary practice location

810 Abbott Blvd
Ste 104
Fort Lee, NJ 07024-4116

Mailing address

810 Abbott Blvd
Ste 104
Fort Lee, NJ 07024-4116
Phone (201) 514-1452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141229000522 NJ Practitioner - Physical Therapist in Private Practice 1456674308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

810 Abbott Blvd
Suite 104
Fort Lee, NJ 07024-4116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hyunseok Lee, DPT Physical Therapist CurrentSince Oct 31, 2016 Accepting new patients

Locations

810 Abbott Blvd
Ste 104
Fort Lee, NJ 07024
Phone (201) 514-1452

Organizations & group practices 1

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": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1548660582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ABBOTT BLVD",
            "address_2": "STE 104",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244116",
            "telephone_number": "201-514-1452",
            "fax_number": "201-523-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ABBOTT BLVD",
            "address_2": "STE 104",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244116",
            "telephone_number": "201-514-1452",
            "fax_number": "201-523-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HYUNSEOK",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-27",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01566300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.