Edward Sang Keun Lee, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

25MA08409800 Issued in NJ

Practice address

140 Bergen St Ste E1620
Newark, NJ 07103-2425

Phone

(973) 972-5377

Fax

(973) 972-8268

NPI assigned

Oct 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Plastic and Reconstructive Surgery

Education

Georgetown University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician Associates of New Jersey IncGroup PAC ID 9830003417, 374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University Hospital Hospital, Newark, NJ, CCN 310119
• Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University Physician Associates of New Jersey Inc

  • Surgery Physician
  • Newark, NJ
  • NPI 1639189236

  Plastic Surgery

  Medicare reassignment Care Compare group NPD
• University Physician Associates of New Jersey Inc

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1760492367
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jersey City Medical Center

  • General Acute Care Hospital
  • Jersey City, NJ
  • NPI 1689744856
  Care Compare affiliation
• Jersey City Medical Center

  • Ambulance
  • Jersey City, NJ
  • NPI 1871738021

  Hospital

  Care Compare affiliation
• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  Care Compare affiliation

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1629265657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST STE E1620",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-5377",
            "fax_number": "973-972-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST STE E1620",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-5377",
            "fax_number": "973-972-8268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1166 Saint Georges Ave",
            "address_purpose": "LOCATION",
            "city": "Avenel",
            "state": "NJ",
            "postal_code": "070011263",
            "country_code": "US",
            "telephone_number": "201-585-9005",
            "fax_number": "201-585-9006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EDWARD",
        "middle_name": "SANG KEUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-03",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "249420-1",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA08409800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elee26890@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "Epic",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dolis Lebreault, APN
• Bomsol Lee, MD
• Brian Seokwon Lee, MD
• Christina Inbok Lee, MD
• Chung Hee Lee, OD
• Hye Soo Lee, DDS
• Hyeuk Jennifer Lee, ANP
• James Lee, M.D.
• Jenny Lee, DO
• Jessica Hae Lyung Lee

• Plastic and Reconstructive Surgery Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Plastic and Reconstructive Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.