Individual provider Active NPI

Jenna Lee, MD

  • General Practice Physician
  • Piscataway, NJ
National Provider Identifier
1629657291
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A195202 Issued in CA
Practice address
675 Hoes LN W
Piscataway, NJ 08854-8021
Phone
(732) 235-7673
Fax
(732) 235-8372
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X A195202 CA Primary

Addresses

Primary practice location

675 Hoes LN W
Piscataway, NJ 08854-8021

Mailing address

675 Hoes LN W
Piscataway, NJ 08854-8021
Phone (732) 235-7673

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
I20250324003049 CA Practitioner - General Practice 4688196272 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195202CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of California, PC General Practice CurrentSince Jan 16, 2025 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1629657291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 HOES LN W",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088548021",
            "telephone_number": "732-235-7673",
            "fax_number": "732-235-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 HOES LN W",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088548021",
            "telephone_number": "732-235-7673",
            "fax_number": "732-235-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A195202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

Verify at the official NPI Registry.