Jaejung Lee

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F402313 Issued in NY

Practice address

200 Tillary St
Brooklyn, NY 11201-3026

Phone

(718) 855-7485

Fax

(718) 855-1317

NPI assigned

Jul 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jlee4048994@nychhc.direct-ci.com

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.

• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407

  Single Specialty

  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127

  Single Specialty

  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469

  Single Specialty

  NPD
• New York City Health and Hospitals Corporation

  • Skilled Nursing Facility
  • New York, NY
  • NPI 1922016781

  Single Specialty

  NPD

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1700339967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 89TH ST",
            "address_2": "APT. 3W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241847",
            "telephone_number": "714-331-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TILLARY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013026",
            "telephone_number": "718-855-7485",
            "fax_number": "718-855-1317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W 89th St",
            "address_2": "Apt. 3W",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100241847",
            "country_code": "US",
            "telephone_number": "714-331-7205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAEJUNG",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402313",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "679880",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyojin Lee, DPT
• Hyun Jee Lee, DDS
• Hyun Young Lee, PHARM.D.
• Hyunseung Lee, FNP
• Isaac Lee, DO
• Jaesoo Lee, M.D.
• Jaewon Lee
• James Lee
• James C Lee, L. AC
• Jane Park Lee, FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.