Active NPI
Jae Yong Lee
- Physical Therapist
- Pottstown, PA
National Provider Identifier
1710488226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT026590
- Practice address
- 1561 Medical Dr
Pottstown, PA 19464-3218 - Phone
- (484) 941-6734
- Fax
- (610) 326-5567
- NPI assigned
- Feb 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT026590 | PA | Primary |
Addresses
Primary practice location
1561 Medical Dr
Pottstown, PA 19464-3218
Mailing address
3809 W Chester Pike Ste 150
Newtown Square, PA 19073-0259
Phone (610) 359-5640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT026590 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519171200000",
"number": "1710488226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3809 W CHESTER PIKE STE 150",
"city": "NEWTOWN SQUARE",
"state": "PA",
"postal_code": "190730259",
"telephone_number": "610-359-5640",
"fax_number": "610-359-1519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1561 MEDICAL DR",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194643218",
"telephone_number": "484-941-6734",
"fax_number": "610-326-5567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JAE",
"middle_name": "YONG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-21",
"last_updated": "2018-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT026590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pottstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.