Active NPI
Jeongah Lee
- Women's Health Nurse Practitioner
- Honolulu, HI
National Provider Identifier
1992322580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 3109
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78619 | HI | MD | Ambulatory Women's Health Care Registered Nurse |
| 3109 | HI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Reproductive Medicine and Gynecology of Hawaii, Inc. | Current | 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
- 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.
-
- Ambulatory Fertility Facility
- Honolulu, HI
- NPI 1639327869
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.