Individual provider Active NPI

Byung Moon Lee, L.AC

  • Acupuncturist
  • Westwood, NJ
National Provider Identifier
1790004349
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00070100 Issued in NJ
Practice address
99 Kinderkamack Rd Ste 302
Westwood, NJ 07675-3020
Phone
(201) 497-8880
Fax
(201) 497-8881
NPI assigned
May 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 004222 NY
Acupuncturist 171100000X AC13304 CA
Acupuncturist 171100000X 25MZ00070100 NJ Primary

Addresses

Primary practice location

99 Kinderkamack Rd Ste 302
Westwood, NJ 07675-3020

Mailing address

99 Kinderkamack Rd
Suite 302
Westwood, NJ 07675-3012
Phone (201) 497-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC13304CAMDAcupuncturist
25MZ00070100NJMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Pureme Acupuncture Wellness Center Acupuncturist PastSince Mar 31, 2024 Accepting new patients

Organizations & group practices 1

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": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1790004349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 KINDERKAMACK RD",
            "address_2": "SUITE 302",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753012",
            "telephone_number": "201-497-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 KINDERKAMACK RD STE 302",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753020",
            "telephone_number": "201-497-8880",
            "fax_number": "201-497-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BYUNG MOON",
        "name_prefix": "Dr.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004222",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13304",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00070100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.