Individual provider Active NPI

Boo Kim Lee, M.D.

  • Family Medicine Physician
  • Yonkers, NY
National Provider Identifier
1659442002
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125638 Issued in NY
Practice address
24, Crisfield Street
Suite 1
Yonkers, NY 10710
Phone
(914) 779-1212
Fax
(914) 779-1208
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X A125638 NY
Family Medicine Physician 207Q00000X 125638 NY Primary
Family Medicine Physician 207Q00000X A125638 NY

Addresses

Primary practice location

24, Crisfield Street
Suite 1
Yonkers, NY 10710

Mailing address

24, Crisfield Street
Suite 1
Yonkers, NY 10710
Phone (914) 779-1212

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
I20090825000316 NY Practitioner - Family Practice 4981758075 Practice locations: Yonkers, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24 Crisfield St
Suite 1
Yonkers, NY 10710-1234
Phone (914) 779-1212

Hospital & facility affiliations

  • St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125638NYMDAcupuncturist

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1659442002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24, CRISFIELD STREET",
            "address_2": "SUITE 1",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10710",
            "telephone_number": "914-779-1212",
            "fax_number": "914-779-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24, CRISFIELD STREET",
            "address_2": "SUITE 1",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10710",
            "telephone_number": "914-779-1212",
            "fax_number": "914-779-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BOO",
        "middle_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "A125638",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "125638",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "A125638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.