Individual provider Active NPI

Yong Soo Lee, MD

  • Internal Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1831830041
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12706400 Issued in NJ
Practice address
20 Prospect Ave Ste 201
Hackensack, NJ 07601-1999
Phone
(551) 996-4849
Fax
(551) 996-8089
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA12706400 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

20 Prospect Ave Ste 201
Hackensack, NJ 07601-1999

Mailing address

150 Bergen St RM I-248
Newark, NJ 07103-2496

Other practice location 1

150 Bergen St Rm I-248
Newark, NJ 07103-2496
Phone (973) 972-6056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250709004559 NJ Practitioner - Internal Medicine 7416461595 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 1, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Internal Medicine Past Accepting new patients

Locations

20 Prospect Ave
Ste 201
Hackensack, NJ 07601
Phone (201) 996-4849

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1831830041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST RM I-248",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 201",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011999",
            "telephone_number": "551-996-4849",
            "fax_number": "551-996-8089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Bergen St Rm I-248",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032496",
            "country_code": "US",
            "telephone_number": "973-972-6056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "YONG",
        "middle_name": "SOO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12706400",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.