Individual provider Active NPI

Ju Di Lee, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1740710953
Registry record updated Apr 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2313601 Issued in MA
Practice address
800 Washington St
Boston, MA 02111-1552
Phone
(617) 636-5000
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN2313601 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111-1552

Mailing address

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3271

Other practice location 2

716 Stevens Ave
Portland, ME 04103-2656
Phone (207) 283-0171

Other identifiers 1

IdentifierTypeStateIssuer
110158030AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191106002891 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577995869 Reassigns benefits to 1 organization
I20221201003055 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577995869 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2313601MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Assurant Anesthesia Associates Inc CurrentSince Nov 27, 2023 Accepting new patients
Honolulu Spine Center, LLC CurrentSince Sep 19, 2024 Accepting new patients
Pratt Anesthesiology Associates, Inc CurrentSince Oct 1, 2019 Accepting new patients
Medstream Anesthesia Hawaii, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 31, 2023 Accepting new patients
Pacific Anesthesia, Inc CurrentSince Nov 15, 2022 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

321 N Kuakini St
Ste 306
Honolulu, HI 96817
Phone (808) 545-1557

500 Ala Moana Blvd
Ste 301
Honolulu, HI 96813
Phone (808) 237-2970

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

Organizations & group practices 5

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682726400000",
    "number": "1740710953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "716 Stevens Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041032656",
            "country_code": "US",
            "telephone_number": "207-283-0171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JU",
        "middle_name": "DI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2023-04-29",
        "certification_date": "2023-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2313601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110158030A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.