Individual provider Active NPI

Justin H Lee, MD

  • Pediatric Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1790941391
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
52531 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-0016
Fax
(602) 933-4318
NPI assigned
Aug 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 52531 AZ
Pediatric Surgery Physician 2086S0120X 52531 AZ Primary
Surgery Physician 208600000X 237400 MA

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4371

Other practice location 1

3333 Burnet Ave
Cincinnati Children's Health Medical Center
Cincinnati, OH 45229-3026
Phone (513) 636-4371

Other identifiers 1

IdentifierTypeStateIssuer
171219MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160829003208 AZ Practitioner - Pediatric Medicine 0648499517 Reassigns benefits to 2 organizations
I20260216000743 OH Practitioner - General Surgery 0648499517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tufts University School of Medicine, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237400MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Aug 5, 2016 Accepting new patients
District Medical Group, Inc CurrentSince Jan 25, 2022 Accepting new patients
District Medical Group, Inc CurrentSince Jan 25, 2022 Accepting new patients
Phoenix Children'S Hospital Pediatrics CurrentSince Aug 5, 2016 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Children'S Hospital Medical Center Pediatrics CurrentSince Dec 11, 2025 Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients
Phoenix Children'S Hospital Past Accepting new patients

Locations

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3341 Solutions Ctr
Chicago, IL 60677

796 Cincinnati Batavia Pike
#6006
Cincinnati, OH 45245
Phone (513) 636-6000

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#2023
Cincinnati, OH 45229
Phone (513) 636-4200

7777 Yankee Rd
#16050
Liberty Township, OH 45044

Interoperability endpoints

  • Direct secure messaging: jlee239901@direct.valleywisehealth.org

Organizations & group practices 8

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": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1790941391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0016",
            "fax_number": "602-933-4318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave",
            "address_2": "Cincinnati Children's Health Medical Center",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-4371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUSTIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-03",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "52531",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "AZ",
            "license": "52531",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "237400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171219",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.