JAEWON LEE CNP
NPI 1558815522
Nurse Practitioner - Family in Grants, NM
About Jaewon Lee Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAEWON LEE CNP (NPI 1558815522) is an individual family provider in Grants, New Mexico, licensed in New Mexico (66164) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, is affiliated with Cibola General Hospital, and maintains a secondary practice location in Tell City.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
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
Jaewon Lee Cnp 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.
Medicare Billing Reassignments
2Medicare 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.
Thoreau, NM 87323
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Dhhs Phs Naihs Crownpoint Hospital
- 265 clinicians in this Medicare group
Rio Rancho, NM 87124
- Reassigned Medicare billing, New Mexico enrollment
- 322 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cibola General Hospital
Critical Access Hospitals · Grants, NMPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 87020 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRANTS, NM 87020
GRANTS, NM 87020
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 1558815522. It was assigned to this individual provider in the NPPES registry on August 8, 2016. The provider is also known as Jae Won Lee Cnp.
Where is Jaewon Lee located?
Jaewon Lee practices at 1217 Bonita St, Grants, NM 87020. The listed phone number is (052) 872-9585.
What is Jaewon Lee's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jaewon Lee enrolled in Medicare?
Yes. Jaewon 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 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: Thoreau Clinic (Thoreau, NM) and Presbyterian Medical Services (Rio Rancho, NM). 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.
Is Jaewon Lee affiliated with any hospitals?
According to CMS data, Jaewon Lee is affiliated with Cibola General Hospital.
When was this NPI record last updated?
The NPPES record for Jaewon Lee was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Jaewon Lee, CNP · NPI 1558815522
Family physician in Grants, New Mexico. Individual provider, active in the CMS NPPES registry since August 8, 2016.
## Identity
- **NPI:** 1558815522 (Entity type: Individual)
- **Enumerated:** August 8, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 66164 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 1217 BONITA ST, Grants, NM 87020-2103
- **Phone:** (052) 872-9585 · **Fax:** (505) 443-8342
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Thoreau Clinic (NPI 1679516702, Thoreau, NM); Presbyterian Medical Services (NPI 1871505032, Rio Rancho, NM) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** January 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1558815522) · Data from the CMS NPPES public registry.