Individual provider Active NPI

Yunkyung Jessica Lee

  • Podiatrist
  • Suffolk, VA
National Provider Identifier
1609525856
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103301471 Issued in VA
Practice address
2790 Godwin Blvd
Suffolk, VA 23434-8151
Phone
(757) 983-8520
NPI assigned
Mar 23, 2022
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103301471 VA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 0103301471 VA

Addresses

Primary practice location

2790 Godwin Blvd
Suffolk, VA 23434-8151

Mailing address

10207 Cardinal Rd
Fairfax, VA 22030-2133
Phone (770) 827-5750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250929001980 DC Practitioner - Podiatry 8022514132 Reassigns benefits to 1 organization
I20251030002069 VA Practitioner - Podiatry 8022514132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10901 Conn Ave
Suite 200
Kensington, MD 20895-1645
Phone (301) 949-2000

1313 Dolley Madison Blvd
Suite 403
MC Lean, VA 22101-3926
Phone (703) 556-8637

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue12
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0103301471VAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Oct 1, 2025 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Oct 1, 2025 Accepting new patients

Locations

10901 Connecticut Ave
Ste 200
Kensington, MD 20895
Phone (301) 949-2000

66 Parkway Ln
Ste 102
Fishersville, VA 22939
Phone (540) 949-5150

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.

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1609525856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10207 CARDINAL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302133",
            "telephone_number": "770-827-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-983-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YUNKYUNG",
        "middle_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301471",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103301471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.