Soo G Lee, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA07426600 Issued in NJ

Practice address

15 Vervalen St
Closter, NJ 07624-2635

Phone

(201) 784-3600

Fax

(201) 784-5677

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Internal Medicine

Education

Temple University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Associates of Englewood, PC

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1952681918
  Medicare reassignment Care Compare group NPD
• Closter Internal Medicine, P.C.

  • Internal Medicine Physician
  • Closter, NJ
  • NPI 1467584284
  Authorized official Same address or phone
• Park Medical Group PA

  • Specialist
  • Harrington Park, NJ
  • NPI 1386685162
  NPD (past)
• Pascack Valley Hospital

  dba The Child Birth Center

  • Clinic/Center
  • Englewood, NJ
  • NPI 1023043593
  NPD (past)
• Pascack Valley Hospital

  • General Acute Care Hospital
  • Westwood, NJ
  • NPI 1811992480
  NPD (past)
• The Park Medical Group, PA

  • Specialist
  • Tenafly, NJ
  • NPI 1275604894
  NPD (past)
• Rockland Endocrine & Diabetes Services PC

  • Specialist
  • Suffern, NY
  • NPI 1245245125
  NPD (past)

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

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679508048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 WESTWOOD AVE FL 2",
            "city": "RIVERVALE",
            "state": "NJ",
            "postal_code": "076756238",
            "telephone_number": "201-358-6774",
            "fax_number": "201-358-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VERVALEN ST",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076242635",
            "telephone_number": "201-784-3600",
            "fax_number": "201-784-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SOO",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07426600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9116508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hae Lee
• Jihyun Lee, M.D.
• Jiyun Lee, L.AC
• Junghye Lee
• Mark Lee
• Young B Lee, MD
• Stephen Leo
• Jennie M Li, M.D.
• Libera Linick, LSW
• Stacey M Linwood, M.D.

• Internal Medicine Physician in Closter, NJ
• Providers in Closter, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.