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JUNG-SUP LEE MD
NPI 1053471243
Internal Medicine in Riverside, CA

Active since December 11, 2006PECOS EnrolledAccepts Medicare Assignment
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505(909) 353-2000 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jung-sup Lee Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUNG-SUP LEE MD (NPI 1053471243) is an individual internal medicine provider in Riverside, California, licensed in California (A67765) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (1997).

NPPES Registry Identity

NPI1053471243
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJUNG-SUP LEECredential: MD
Location Address10800 MAGNOLIA AVERiverside, CA 92505-3043
Mailing Address10800 Magnolia AveRiverside, CA 92505-3043 · (909) 353-2000
Phone(909) 353-2000
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 1997
Enumeration DateDecember 11, 2006
Last NPPES UpdateDecember 6, 2021
✔ NPI 1053471243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A67765
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
10800 MAGNOLIA AVE, Riverside, CA 92505
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jung-sup Lee Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991868523
PECOS Enrollment IDI20090108000383
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jung-sup Lee reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
Same address
Health Maintenance Organization
10800 MAGNOLIA AVE
Riverside, CA 92505
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1316979834 (866) 984-7483

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92505 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAISER PERMANENTE
General Acute Care Hospital
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (951) 353-4988
PATRICK T MC GILL PA
Physician Assistant
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000
ROBERT L. RUDEK MD
Surgery
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000
RICHARD M. BRADBURNE MD
Internal Medicine (Critical Care Medicine)
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000
SUNG JIN JOHN MD
Family Medicine
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000
SHELLY C. THIO MD
Internal Medicine
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000
GREGORY MARRUJO MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000
REBECCA J SEAWELL NP
Nurse Practitioner
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505
Riverside County (909) 353-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jung-sup Lee's NPI number?

The NPI number for Jung-sup Lee is 1053471243. It was assigned to this individual provider in the NPPES registry on December 11, 2006.

Where is Jung-sup Lee located?

Jung-sup Lee practices at 10800 Magnolia Ave, Riverside, CA 92505. The listed phone number is (909) 353-2000.

What is Jung-sup Lee's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jung-sup Lee enrolled in Medicare?

Yes. Jung-sup Lee is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jung-sup Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jung-sup Lee reassigns Medicare benefits to Southern California Permanente Medical Group (Riverside, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jung-sup Lee's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jung-sup Lee was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.