Individual provider Active NPI

John Kwanghyuk Lee, MD

  • Internal Medicine Physician
  • Fullerton, CA
National Provider Identifier
1598721284
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66137 Issued in CA
Practice address
400 N. Euclid St
Fullerton, CA 91748-1625
Phone
(626) 964-3326
Fax
(626) 964-3346
NPI assigned
Apr 22, 2006
Last updated
Oct 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66137 CA Primary

Addresses

Primary practice location

400 N. Euclid St
Fullerton, CA 91748-1625

Mailing address

400 N Euclid St
Fullerton, CA 92832-1625
Phone (626) 964-3326

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040721001742 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8628058542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

400 N Euclid St
Fullerton, CA 92832-1625
Phone (714) 879-8700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
85.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66137CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John K. Lee, M.D., Inc. CurrentSince Jan 15, 2007 Accepting new patients
St Jude Hospital Inc PastSince Jan 15, 2007 Accepting new patients
Art Physical Therapy Past Accepting new patients

Locations

400 N Euclid St
Fullerton, CA 92832
Phone (626) 964-3326

400 N Euclid St
Ste 100
Fullerton, CA 92832

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 4

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1598721284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N EUCLID ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321625",
            "telephone_number": "626-964-3326",
            "fax_number": "626-964-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N. EUCLID ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "917481625",
            "telephone_number": "626-964-3326",
            "fax_number": "626-964-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "KWANGHYUK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.