Soon-Duck Lee, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

342832 Issued in NY

Practice address

1963 Williamsbridge Rd
Bronx, NY 10461-1604

Phone

(646) 530-8447

Fax

(718) 577-5462

NPI assigned

Jun 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kezmed Medical PCGroup PAC ID 4688898687, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Kezmed Medical PC

  • Cardiovascular Disease Physician
  • Dix Hills, NY
  • NPI 1366871378

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1609396258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 CHARLES PL",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051309",
            "telephone_number": "201-450-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611604",
            "telephone_number": "646-530-8447",
            "fax_number": "718-577-5462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "685 Bergen Blvd",
            "address_purpose": "LOCATION",
            "city": "Ridgefield",
            "state": "NJ",
            "postal_code": "076571400",
            "country_code": "US",
            "telephone_number": "917-783-4080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 Charles Pl",
            "address_purpose": "LOCATION",
            "city": "Leonia",
            "state": "NJ",
            "postal_code": "076051309",
            "country_code": "US",
            "telephone_number": "201-450-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SOON-DUCK",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-25",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342832",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "522996",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER IN FAMILY HEALTH",
            "identifier": "342832",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "slee@kezmed.com",
            "affiliation": "N",
            "address_1": "403 Charles Pl",
            "city": "Leonia",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076051309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon Lan Lee
• Shinyoung Lee
• Somin Lee, MD
• Soo Kyoung Lee, M.D.
• Soo-Il Lee, PH.D., CTRS, LMHC
• Sophia Lee
• Soyoung Lee, NP
• Su Jung Lee
• Su Yeon Lee, MD
• Sukjoo Lee

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.