Individual provider Active NPI

Jessica May Lee, NP-C

  • Nurse Practitioner
  • Dallas, PA
National Provider Identifier
1730773243
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP022307 Issued in PA
Practice address
114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone
(570) 255-1178
Fax
(570) 255-1156
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP022307 PA
Nurse Practitioner 363L00000X SP022307 PA Primary

Addresses

Primary practice location

114 LT Michael Cleary Dr
Dallas, PA 18612-1649

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624003562 PA Practitioner - Nurse Practitioner 9032510219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

560 Pierce St
Kingston, PA 18704-5716
Phone (570) 714-5810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP022307PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jun 19, 2023 Accepting new patients
Geisinger Medical Oncology Lock Haven CurrentSince Jun 19, 2023 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Scranton Heart Institute, P.C. CurrentSince May 1, 2021 Accepting new patients
Geisinger Clinic Past Accepting new patients
Wayne Memorial Hospital PastSince May 1, 2021 Accepting new patients

Locations

102 N Abington Rd
Ste 103
Clarks Green, PA 18411
Phone (570) 586-0246

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1730773243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LT MICHAEL CLEARY DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121649",
            "telephone_number": "570-255-1178",
            "fax_number": "570-255-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "middle_name": "MAY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022307",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP022307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, PA

Sources for this page

Verify at the official NPI Registry.