Individual provider Active NPI

Jeongah Lee

  • Women's Health Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1992322580
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3109 Issued in HI
Practice address
1585 Kapiolani Blvd Ste 1800
Honolulu, HI 96814-4500
Phone
(808) 545-2800
Fax
(808) 262-3744
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 78619 HI
Women's Health Nurse Practitioner 363LW0102X 3109 HI Primary

Addresses

Primary practice location

1585 Kapiolani Blvd Ste 1800
Honolulu, HI 96814-4500

Mailing address

1401 S Beretania St Ste 250
Honolulu, HI 96814-1876
Phone (808) 545-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78619HIMDAmbulatory Women's Health Care Registered Nurse
3109HIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Reproductive Medicine and Gynecology of Hawaii, Inc. CurrentSince May 16, 2023 Accepting new patients

Locations

1585 Kapiolani Blvd
Ste 1800
Honolulu, HI 96814
Phone (808) 545-2800

1401 S Beretania St
Ste 250
Honolulu, HI 96814
Phone (808) 545-2800

Interoperability endpoints

  • Direct secure messaging: jeongah.lee@fih.eclinicaldirectplus.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1992322580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 250",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141876",
            "telephone_number": "808-545-2800",
            "fax_number": "808-262-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 KAPIOLANI BLVD STE 1800",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144500",
            "telephone_number": "808-545-2800",
            "fax_number": "808-262-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEONGAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "HI",
            "license": "78619",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "HI",
            "license": "3109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.