Individual provider Active NPI

David Won Lee, M.D.

  • Family Medicine Physician
  • Fort Lee, NJ
National Provider Identifier
1922144401
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA04497700 Issued in NJ
Practice address
1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748
Phone
(201) 224-0011
Fax
(201) 224-8920
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA44977 NJ
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 25MA04497700 NJ Primary

Addresses

Primary practice location

1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748

Mailing address

1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748
Phone (201) 224-0011

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
I20080103000315 NJ Practitioner - Family Practice 5698855690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hudson MD GroupGroup PAC ID 6103240478, 110 clinicians

Practice addresses (Care Compare)

1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748
Phone (201) 224-0011

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA44977NJMDSpecialist
25MA04497700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson MD Group Single Specialty CurrentSince May 1, 2020 Accepting new patients

Locations

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

525 Main St
#1
Fort Lee, NJ 07024

784 Grand Ave
Ste 201
Ridgefield, NJ 07657
Phone (201) 346-0999

443 Northfield Ave
West Orange, NJ 07052
Phone (973) 324-0103

Interoperability endpoints

  • Direct secure messaging: dlee@3498.mdlanddirect.com

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.

Hospital & facility affiliations 5

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1922144401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 ANDERSON AVE",
            "address_2": "SUITE 204",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242748",
            "telephone_number": "201-224-0011",
            "fax_number": "201-224-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 ANDERSON AVE",
            "address_2": "SUITE 204",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242748",
            "telephone_number": "201-224-0011",
            "fax_number": "201-224-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAVID",
        "middle_name": "WON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA44977",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04497700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.