NPIMap

Individual provider Active NPI

Jisoo Lee, M.D.

  • Pulmonary Disease Physician
  • Providence, RI
National Provider Identifier
1962820969
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD16345 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-4000
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD16345 RI
Internal Medicine Physician 207R00000X MD16345 RI
Pulmonary Disease Physician 207RP1001X MD16345 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

Dept 3010, PO Box 986524
Boston, MA 02298-6524
Phone (401) 443-4992

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707001887 RI Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 5395961056 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians
Brown MedicineGroup PAC ID 0446159776, 220 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4741

Hospital & facility affiliations

  • Hopehealth Hospice & Palliative Care Hospice, Providence, RI, CCN 411500
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Newport Hospital Hospital, Newport, RI, CCN 410006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16345RIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group Inc CurrentSince Jan 1, 2026 Accepting new patients
The Miriam Hospital CurrentSince Oct 27, 2022 Accepting new patients
Brown Medicine CurrentSince Aug 1, 2020 Accepting new patients
The Miriam Hospital CurrentSince Oct 27, 2022 Accepting new patients
Brown Medicine Internal Medicine Current Accepting new patients
Brown Medicine Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Newport Hospital CurrentSince Aug 6, 2023 Accepting new patients
Newport Hospital CurrentSince Aug 6, 2023 Accepting new patients
Brown Medicine Critical Care Medicine Past Accepting new patients

Locations

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Interoperability endpoints

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

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 7

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1962820969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3010, PO BOX 986524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986524",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JISOO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "RI",
            "license": "MD16345",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16345",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "RI",
            "license": "MD16345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.