Active NPI
Dianna Jinjoo Lee
- Physician Assistant
- Boston, MA
National Provider Identifier
1982381828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 360 Huntington Ave
Boston, MA 02115-5005 - Phone
- (617) 373-2000
- NPI assigned
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
360 Huntington Ave
Boston, MA 02115-5005
Mailing address
9 Mount Vernon St Apt 1
Dorchester, MA 02125-1791
Phone (631) 512-2168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250319003062 | MA | Order and Referring Only - Physician Assistant | 9931621943 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1982381828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 MOUNT VERNON ST APT 1",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021251791",
"telephone_number": "631-512-2168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155005",
"telephone_number": "617-373-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DIANNA",
"middle_name": "JINJOO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.