Individual provider Active NPI

Eunjin Lee, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Prescott, AZ
National Provider Identifier
1730678343
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
R78485 Issued in AZ
Practice address
1001 Division St
Prescott, AZ 86301-1601
Phone
(928) 775-5567
Fax
(928) 772-1522
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R78485 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X R78485 AZ Primary

Addresses

Primary practice location

1001 Division St
Prescott, AZ 86301-1601

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elee1440750@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220824003470 AZ Practitioner - Hospice/Palliative Care 5092117945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

802 Ainsworth Dr
Suite B
Prescott, AZ 86301-1623
Phone (928) 445-1232

Hospital & facility affiliations

  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R78485AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Sep 1, 2022 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Sep 1, 2022 Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

802 Ainsworth Dr
Ste B
Prescott, AZ 86301
Phone (928) 445-1232

1001 Division St
Prescott, AZ 86301
Phone (928) 445-4818

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

Interoperability endpoints

  • Direct secure messaging: eunjin.lee.1@18107.direct.athenahealth.com

Organizations & group practices 4

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.

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1730678343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 DIVISION ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011601",
            "telephone_number": "928-775-5567",
            "fax_number": "928-772-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUNJIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R78485",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "AZ",
            "license": "R78485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elee1440750@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.