NPIMap

Individual provider Active NPI

Boo W Lee, MD

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1750466728
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A383P3 Issued in CA
Practice address
2040 Forest Avenue
Suite #3
San Jose, CA 95128
Phone
(408) 977-1310
Fax
(408) 977-0140
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A383P3 CA Primary

Addresses

Primary practice location

2040 Forest Avenue
Suite #3
San Jose, CA 95128

Mailing address

2040 Forest Avenue
Suite #3
San Jose, CA 95128
Phone (408) 977-1310

Other identifiers 1

IdentifierTypeStateIssuer
00A383930MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100901000109 CA Practitioner - Internal Medicine 8325162159 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2040 Forest Ave
Suite 3
San Jose, CA 95128-4800
Phone (408) 977-1310

Hospital & facility affiliations

  • South Springs Home Health Care Home health agency, San Jose, CA, CCN 059620
  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038
  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380
  • Skyline Healthcare Center - San Jose Nursing home, San Jose, CA, CCN 055318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A383P3CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
County of Santa Clara Past Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: blee42021@santaclaravalley.direct-ci.net

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 4

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750466728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 FOREST AVENUE",
            "address_2": "SUITE #3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-977-1310",
            "fax_number": "408-977-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 FOREST AVENUE",
            "address_2": "SUITE #3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-977-1310",
            "fax_number": "408-977-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BOO",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A383P3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A383930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.