Individual provider Active NPI

Ji Youn Lee

  • Primary Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1912435553
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95006184 Issued in CA
Practice address
501 S Oxford Ave Apt 17
Los Angeles, CA 90020-4228
Phone
(213) 505-7667
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95006184 CA Primary

Addresses

Primary practice location

501 S Oxford Ave Apt 17
Los Angeles, CA 90020-4228

Mailing address

501 S Oxford Ave Apt 17
Los Angeles, CA 90020-4228
Phone (213) 505-7667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210407002684 CA Practitioner - Nurse Practitioner 2466869516 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95006184CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kwang He Won Health Center CurrentSince Apr 1, 2021 Accepting new patients
Carehome Doctors, Inc PastSince Jul 24, 2022 Accepting new patients

Locations

815 S Ardmore Ave
Fl 1
Los Angeles, CA 90005
Phone (213) 385-0448

Interoperability endpoints

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

Organizations & group practices 2

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": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912435553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S OXFORD AVE APT 17",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204228",
            "telephone_number": "213-505-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S OXFORD AVE APT 17",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204228",
            "telephone_number": "213-505-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JI YOUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95006184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.