Individual provider Active NPI

Juyeon Lee

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1639584972
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C198540 Issued in CA
Practice address
746 The Alameda Ste 10
San Jose, CA 95126-3178
Phone
(888) 663-6331
NPI assigned
Jun 25, 2014
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 288066 NY
Family Medicine Physician 207Q00000X MT206964 PA
Family Medicine Physician 207Q00000X C198540 CA Primary

Addresses

Primary practice location

746 The Alameda Ste 10
San Jose, CA 95126-3178

Mailing address

1 Embarcadero Ctr
San Francisco, CA 94111-3628
Phone (415) 658-6791

Other practice location 1

8815 Germantown Ave Fl 5
Philadelphia, PA 19118-2722
Phone (215) 248-8145

Other practice location 2

489 5th Ave
New York, NY 10017-6109
Phone (212) 530-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170901001368 NY Practitioner - Family Practice 2466766415 Reassigns benefits to 1 organization
I20241105000676 CA Practitioner - Family Practice 2466766415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

746 The Alameda
Suite 10
San Jose, CA 95126-3178
Phone (408) 228-1020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C198540CAMDFamily Medicine Physician
288066NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. Family Medicine CurrentSince Dec 2, 2024 Accepting new patients
Mount Sinai School of Medicine Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
One Medical Group, Inc Family Medicine CurrentSince Dec 2, 2024 Accepting new patients
Mount Sinai School of Medicine PastSince Feb 1, 2019 Accepting new patients

Locations

590 Forest Ave
Palo Alto, CA 94301
Phone (650) 288-4080

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

746 The Alameda
Ste 10
San Jose, CA 95126
Phone (408) 228-1020

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

489 5th Ave
Fl 3
New York, NY 10017
Phone (212) 440-0658

515 Madison Ave
Fl 25
New York, NY 10022
Phone (212) 530-0650

515 Madison Ave
Fl 25
New York, NY 10022
Phone (212) 530-0650

Organizations & group practices 4

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1639584972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 THE ALAMEDA STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263178",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8815 Germantown Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191182722",
            "country_code": "US",
            "telephone_number": "215-248-8145",
            "fax_number": "215-248-8852",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "489 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100176109",
            "country_code": "US",
            "telephone_number": "212-530-2288",
            "fax_number": "212-867-4353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUYEON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "288066",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT206964",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C198540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.