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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JAEWON LEE MD
NPI 1063115178
Internal Medicine in Boston, MA

Active since March 27, 2023PECOS Enrolled

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 25, 2026, May 20, 2026, Mar 27, 2023 (3 updates tracked since 2023).

About Jaewon Lee Md NPPES

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

JAEWON LEE MD (NPI 1063115178) is an individual internal medicine provider in Boston, Massachusetts, licensed in Massachusetts (1027631) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Boston, and is a graduate of Saint Louis University School Of Medicine (2023).

NPPES Registry Identity

NPI1063115178
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameJAEWON LEECredential: MD
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address55 Fruit StBoston, MA 02114-2621
Phone(617) 231-9943
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 2023
Enumeration DateMarch 27, 2023
Last NPPES UpdateJune 29, 20263 updates tracked since enumeration
NPPES CertifiedJune 29, 2026
✔ NPI 1063115178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MA · 1027631
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.
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Location 1

Location 175 Francis StBoston, MA 02115-6110 · Phone (617) 732-5500

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaewon Lee Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517311830
PECOS Enrollment IDI20260609000465
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Jaewon Lee's NPI number?

The NPI number for Jaewon Lee is 1063115178. It was assigned to this individual provider in the NPPES registry on March 27, 2023.

Where is Jaewon Lee located?

Jaewon Lee practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 231-9943.

What is Jaewon Lee's specialty?

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

Is Jaewon Lee enrolled in Medicare?

Yes. Jaewon Lee is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jaewon Lee was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.