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JAEWON LEE NP
NPI 1467941401
Nurse Practitioner in Tustin, CA

Active since May 04, 2018PECOS Enrolled
161 FASHION LN STE 209, TUSTIN, CA 92780(714) 922-0017(714) 364-5415 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 13, 2026, May 21, 2025, Mar 16, 2023 and 1 more (4 updates tracked since 2018).

About Jaewon Lee Np NPPES

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

JAEWON LEE NP (NPI 1467941401) is an individual nurse practitioner in Tustin, California, licensed in California (NP95008747) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467941401
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJAEWON LEECredential: NP
Location Address161 FASHION LN STE 209Tustin, CA 92780-3331
Mailing Address1950 W Corporate Way # 60175Anaheim, CA 92801-5373 · (714) 922-0017 · Fax (714) 364-5415
Phone(714) 922-0017
Fax(714) 364-5415
Sole ProprietorNo
Enumeration DateMay 4, 2018
Last NPPES UpdateAugust 13, 20264 updates tracked since enumeration
NPPES CertifiedAugust 13, 2026
✔ NPI 1467941401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · NP95008747
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
161 FASHION LN STE 209, Tustin, CA 92780
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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)

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

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 Reassignments

2

Medicare enrollment records show Jaewon Lee reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dispatchhealth-Ca, PC
0.1 mi
Emergency Medicine
140 CENTENNIAL WAY
Tustin, CA 92780
  • Reassigned Medicare billing, California enrollment
  • 78 clinicians in this Medicare group
NPI 1639752553 (303) 904-7240
Families Together Of Orange County
0.8 mi
Clinic/Center
661 W 1ST ST, STE. G
Tustin, CA 92780
  • Reassigned Medicare billing, California enrollment
  • 86 clinicians in this Medicare group
NPI 1194122457 (714) 665-9890

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 92780 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.

ACORN TELEMAT NURSING, APC
Clinic/Center
161 FASHION LN STE 209
TUSTIN, CA 92780
Orange County (714) 922-0017

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 1467941401. It was assigned to this individual provider in the NPPES registry on May 4, 2018.

Where is Jaewon Lee located?

Jaewon Lee practices at 161 Fashion Ln Ste 209, Tustin, CA 92780. The listed phone number is (714) 922-0017.

What is Jaewon Lee's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jaewon Lee enrolled in Medicare?

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

Which organizations bill Medicare for Jaewon Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaewon Lee reassigns Medicare benefits to 2 organizations: Dispatchhealth-Ca, PC (Tustin, CA) and Families Together Of Orange County (Tustin, CA). Each 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 Jaewon 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 Jaewon Lee was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.