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YOUNG TAE LEE PNHNP
NPI 1225780562
Nurse Practitioner - Psychiatric/Mental Health in Agoura Hills, CA

Active since January 18, 2022PECOS Enrolled
30423 CANWOOD ST STE 123, AGOURA HILLS, CA 91301(818) 385-1219(818) 385-1600 Get Directions Write a Review

NPPES record last updated: February 22, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 28, 2022, Jan 18, 2022 (2 updates tracked since 2022).

About Young Tae Lee Pnhnp NPPES

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

YOUNG TAE LEE PNHNP (NPI 1225780562) is an individual psychiatric/mental health provider in Agoura Hills, California, licensed in California (95019749) and active in the NPI registry since January 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1225780562
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameYOUNG TAE LEECredential: PNHNP
Location Address30423 CANWOOD ST STE 123Agoura Hills, CA 91301-4314
Mailing Address30423 Canwood St Ste 123Agoura Hills, CA 91301-4314 · (818) 385-1219
Phone(818) 385-1219
Fax(818) 385-1600
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJanuary 18, 2022
Last NPPES UpdateFebruary 22, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 22, 2024
✔ NPI 1225780562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95019749
Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License 95158737 (CA)
30423 CANWOOD ST STE 123, Agoura Hills, CA 91301
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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 (PECOS)

Young Tae Lee Pnhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022486679
PECOS Enrollment IDI20221201002402
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 Young Tae Lee reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medi Psych Services Inc
18 mi
Child & Adolescent Psychiatry
15260 VENTURA BLVD STE 1200
Sherman Oaks, CA 91403
  • Reassigned Medicare billing, California enrollment
  • 43 clinicians in this Medicare group
NPI 1326665316 (310) 871-0670

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 91301 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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

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

ROBERT P KAHN-ROSE, INC.
Specialist
30423 CANWOOD ST STE 123
AGOURA HILLS, CA 91301
Los Angeles County (818) 385-1219

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 Young Tae Lee's NPI number?

The NPI number for Young Tae Lee is 1225780562. It was assigned to this individual provider in the NPPES registry on January 18, 2022.

Where is Young Tae Lee located?

Young Tae Lee practices at 30423 Canwood St Ste 123, Agoura Hills, CA 91301. The listed phone number is (818) 385-1219.

What is Young Tae Lee's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Young Tae Lee enrolled in Medicare?

Yes. Young Tae Lee is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Young Tae Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Young Tae Lee reassigns Medicare benefits to Medi Psych Services Inc (Sherman Oaks, 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 Young Tae 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 Young Tae Lee was last updated on February 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.