Individual provider Active NPI

Sun Ok Lee, APRN

  • Primary Care Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1750509063
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
189236 Issued in MA
Practice address
130 Marshall Rd
Lowell, MA 01852-5130
Phone
(800) 865-3384
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 189236 MA
Primary Care Nurse Practitioner 363LP2300X 189236 MA Primary

Addresses

Primary practice location

130 Marshall Rd
Lowell, MA 01852-5130

Mailing address

53 River St Apt 402
Billerica, MA 01821-1873
Phone (978) 671-9000

Other practice location 1

940 Belmont St
Brockton, MA 02301-5596
Phone (774) 826-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160606000475 MA Order and Referring Only - Nurse Practitioner 5890789549

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brighton Family Practice, Inc Past Accepting new patients
Hallmark Health Medical Associates Inc Adult Health Past Accepting new patients
Preventive Medicine Associates Past Accepting new patients

Organizations & group practices 3

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1750509063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 RIVER ST APT 402",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018211873",
            "telephone_number": "978-671-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MARSHALL RD",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018525130",
            "telephone_number": "800-865-3384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015596",
            "country_code": "US",
            "telephone_number": "774-826-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUN",
        "middle_name": "OK",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "189236",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "189236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.