Individual provider Active NPI

Haesoon Lee, M.D.

  • Pediatric Pulmonology Physician
  • Brooklyn, NY
National Provider Identifier
1659395358
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
129098-1 Issued in NY
Practice address
45 Clarkson Ave
Suite B4-333
Brooklyn, NY 11203
Phone
(718) 270-4714
Fax
(718) 270-1985
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 129098-1 NY Primary

Addresses

Primary practice location

45 Clarkson Ave
Suite B4-333
Brooklyn, NY 11203

Mailing address

45 Clarkson Ave
Box 1262
Brooklyn, NY 11203
Phone (718) 270-8867

Other identifiers 1

IdentifierTypeStateIssuer
00685447MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061122000131 NY Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 9436111812 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129098-1NYMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Family Care Center, Inc. CurrentSince Feb 28, 2018 Accepting new patients
Brookdale Family Care Center, Inc. CurrentSince Feb 28, 2018 Accepting new patients
Urban Strategies Brookdale Family Care Center Inc CurrentSince Feb 28, 2018 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Feb 28, 2018 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Feb 28, 2018 Accepting new patients
University Physicians of Brooklyn, Inc. Pediatric Pulmonology Past Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1873 Eastern Pkwy
Brooklyn, NY 11233
Phone (718) 240-5133

465 New Lots Ave
Brooklyn, NY 11207
Phone (718) 240-5133

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

2554 Linden Blvd
Brooklyn, NY 11208
Phone (718) 240-5132

1095 Flatbush Ave
Brooklyn, NY 11226
Phone (718) 240-5132

Organizations & group practices 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659395358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-270-8867",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CLARKSON AVE",
            "address_2": "SUITE B4-333",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-270-4714",
            "fax_number": "718-270-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HAESOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "129098-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00685447",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.