JAEYOP LEE MD, PHD
NPI 1174186597
General Practice in New York, NY

Q: What is Jaeyop Lee's NPI number?

The NPI number for Jaeyop Lee is 1174186597. It was assigned to this individual provider in the NPPES registry on April 22, 2019.

Q: What is Jaeyop Lee's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Jaeyop Lee was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since April 22, 2019PECOS EnrolledAccepts Medicare Assignment

1275 YORK AVE, NEW YORK, NY 10065(212) 639-2000 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2025, Jun 1, 2023, Apr 22, 2019 (3 updates tracked since 2019).

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About Jaeyop Lee Md, Phd NPPES

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

JAEYOP LEE MD, PHD (NPI 1174186597) is an individual general practice provider in New York, New York, licensed in New York (310062-01) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1174186597

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameJAEYOP LEECredential: MD, PHD

Location Address1275 YORK AVENew York, NY 10065-6007

Mailing Address4427 Purves StLong Island City, NY 11101-2946

Phone(212) 639-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 22, 2019

Last NPPES UpdateMay 19, 20253 updates tracked since enumeration

NPPES CertifiedMay 19, 2025

✔ NPI 1174186597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in NY · 310062-01

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1275 YORK AVE, New York, NY 10065

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaeyop Lee Md, Phd 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 ID8123356706

PECOS Enrollment IDI20250826003458

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.

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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.

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