Individual provider Active NPI

Ji Won Lee, DO

  • Family Medicine Physician
  • Altoona, PA
National Provider Identifier
1871052407
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS020767 Issued in PA
Practice address
620 Howard Ave
Altoona, PA 16601-4804
Phone
(814) 889-2011
NPI assigned
Mar 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS020767 PA Primary

Addresses

Primary practice location

620 Howard Ave
Altoona, PA 16601-4804

Mailing address

2 Hot Metal Street
Quantum One Ste N357
Pittsburgh, PA 15203-2348
Phone (412) 432-5868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220810003683 PA Practitioner - Family Practice 5799028411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc AltoonaGroup PAC ID 8426962465, 126 clinicians

Practice addresses (Care Compare)

2 Hot Meal St
Pittsburgh, PA 15203-2348

620 Howard Ave
Altoona, PA 16601-4804
Phone (814) 889-2866

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince Jul 1, 2022 Accepting new patients
Upmc Altoona CurrentSince Jul 1, 2022 Accepting new patients
Upmc Altoona Past Accepting new patients

Locations

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

501 Howard Ave
Ste F2
Altoona, PA 16601
Phone (814) 889-2020

Interoperability endpoints

  • Direct secure messaging: jlee150070@upmc.direct-ci.com
  • Direct secure messaging: ji.w.lee@upmcdirect.com

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.

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1871052407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HOT METAL STREET",
            "address_2": "QUANTUM ONE STE N357",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032348",
            "telephone_number": "412-432-5868",
            "fax_number": "412-647-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HOWARD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014804",
            "telephone_number": "814-889-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JI WON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS020767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.