PAUL JUNG-KOON LEE M.D. NPI 1790709970
Pediatrics - Pediatric Infectious Diseases in Mineola, NY

About PAUL JUNG-KOON LEE M.D.

Paul Lee is a pediatrician established in Mineola, New York and his medical specialization is Pediatrics with a focus in pediatric infectious diseases with more than 34 years of experience. He graduated from New York Medical College in 1989. The NPI number of Paul Lee is 1790709970 and was assigned on July 2006. The practitioner's primary taxonomy code is 2080P0208X with license number 188644 (NY). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1790709970
Provider Name PAUL JUNG-KOON LEE M.D.
Location Address120 MINEOLA BLVD SUITE 210 MINEOLA, NY 11501
Location Phone(516) 663-4600
Mailing Address222 STATION PLZ N SUITE 611 MINEOLA, NY 11501
GenderMale
NPI Entity TypeIndividual
Medical School NameNEW YORK MEDICAL COLLEGE
Graduation Year1989
Is Sole Proprietor?No
Enumeration Date07-27-2006
Last Update Date07-08-2007

A pediatrician like Paul Jung-koon Lee M.d. is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.Paul Lee is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Paul Lee is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Good Samaritan Hospital Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 85.3, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code2080P0208X
ClassificationPediatrics
TypeAllopathic & Osteopathic Physicians
SpecializationPediatric Infectious Diseases
License No.188644
License StateNY
Taxonomy DescriptionA pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

PAUL JUNG-KOON LEE M.D.
120 MINEOLA BLVD
SUITE 210
MINEOLA, NY
ZIP 11501
Phone: (516) 663-4600
Fax: (516) 663-3793

Get Directions


Mailing Address

PAUL JUNG-KOON LEE M.D.
222 STATION PLZ N
SUITE 611
MINEOLA, NY
ZIP 11501
Phone: (516) 663-2532
Fax: (516) 663-2233


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID1850440249
PECOS Enrollment IDI20090513000594
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 75.4
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% 94.6
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 85.3
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Paul Lee is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
GOOD SAMARITAN HOSPITAL MEDICAL CENTER1000 MONTAUK HIGHWAY
WEST ISLIP, NY 11795
(631) 376-3000Acute Care Hospitals330286

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
01933664MEDICAID (05)NY

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1790709970
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2718014018914
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 4 + 0 + 1 + 8 + 9 + 1 + 4 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1790709970 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1609869734 VALERIE CUCCO DO
Individual
Obstetrics & Gynecology120 MINEOLA BLVD SUITE 100
MINEOLA, NY 11501
(516) 663-3010
1487647525 ADAM FLISSER MD
Individual
Obstetrics & Gynecology120 MINEOLA BLVD SUITE 100
MINEOLA, NY 11501
(516) 663-3010
1104819242 FREDRIC MOON DO
Individual
Obstetrics & Gynecology120 MINEOLA BLVD SUITE 100
MINEOLA, NY 11501
(516) 663-3010
1841285152 DIANA HYEJUNG KONG NP
Individual
Nurse Practitioner (Pediatrics)120 MINEOLA BLVD SUITE 210
MINEOLA, NY 11501
(516) 663-4600
1639150949 JOHN J GONCALVES MD
Individual
Thoracic Surgery (Cardiothoracic Vascular Surgery)120 MINEOLA BLVD SUITE 300
MINEOLA, NY 11501
(516) 663-4400
1265414791 REESE A WAIN MD
Individual
Surgery (Vascular Surgery)120 MINEOLA BLVD SUITE 300
MINEOLA, NY 11501
(516) 663-4400
1801879648 PATRICE VORWERK M.D.
Individual
Radiology (Diagnostic Radiology)120 MINEOLA BLVD
MINEOLA, NY 11501
(516) 663-4510
1922063841MRS. BARBARA KIMBERLY MOSKOWITZ ANP
Individual
Nurse Practitioner (Adult Health)120 MINEOLA BLVD SUITE 320
MINEOLA, NY 11501
(516) 663-3300
1790741304 CYNTHIA ARLEEN FRETWELL MD
Individual
Obstetrics & Gynecology120 MINEOLA BLVD SUITE 100
MINEOLA, NY 11501
(516) 663-3010
1871543983WINTHROP SURGICAL ASSOCIATES, PC
Organization
Surgery120 MINEOLA BLVD SUITE 320
MINEOLA, NY 11501
(516) 663-3300
1992748677 BARBARA E CROCITTO NP
Individual
Nurse Practitioner120 MINEOLA BLVD STE 10 LOWER LEVEL
MINEOLA, NY 11501
(516) 663-4510
1265475941 SUSANA H FUCHS MD
Individual
Radiology (Diagnostic Radiology)120 MINEOLA BLVD SUITE 10 LOWER LEVEL
MINEOLA, NY 11501
(516) 663-4510
1386688984 TRACY JAE WON LEE MD
Individual
Radiology (Body Imaging)120 MINEOLA BLVD STE 10 LOWER LEVEL
MINEOLA, NY 11501
(516) 663-4510
1073532461 PETER S. FINAMORE MD
Individual
Obstetrics & Gynecology120 MINEOLA BLVD SUITE 100
MINEOLA, NY 11501
(516) 663-3010
1356362685 IGAL FLIGMAN M.D.
Individual
Pediatrics (Pediatric Hematology-Oncology)120 MINEOLA BLVD SUITE 460
MINEOLA, NY 11501
(516) 663-9400
1760403927 LEONARD ROY KRILOV M.D.
Individual
Pediatrics (Pediatric Infectious Diseases)120 MINEOLA BLVD SUITE 210
MINEOLA, NY 11501
(516) 663-9570
1770597817 PHILIP GEORGE SCIMECA M.D.
Individual
Pediatrics (Pediatric Hematology-Oncology)120 MINEOLA BLVD SUITE 460
MINEOLA, NY 11501
(516) 663-9400
1407860570 MARK EFRAIM WEINBLATT M.D.
Individual
Pediatrics (Pediatric Hematology-Oncology)120 MINEOLA BLVD SUITE 460
MINEOLA, NY 11501
(516) 663-9400
1972519015 NAOMI P. MOSKOWITZ-BROOKS M.D.
Individual
Pediatrics (Pediatric Hematology-Oncology)120 MINEOLA BLVD SUITE 460
MINEOLA, NY 11501
(516) 663-9400
1104901206 ALISHA R OROPALLO M.D.
Individual
Surgery (Vascular Surgery)120 MINEOLA BLVD SUITE 300
MINEOLA, NY 11501
(516) 663-4400

Frequently Asked Questions

What is Paul Lee M.D. NPI number?

The NPI number assigned to Paul Lee M.D. is 1790709970, registered as an "individual" on July 27, 2006

Where is Paul Lee M.D. located?

The provider is located at 120 Mineola Blvd Suite 210 Mineola, Ny 11501 and the phone number is (516) 663-4600

Which is Paul Lee M.D. specialty?

The provider's speciality is Pediatrics with a focus in Pediatric Infectious Diseases

How many years of experience does Paul Lee M.D. have?

The provider has more than 34 years of experience. He graduated from New York Medical College in 1989.

What insurance does Paul Lee M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Paul Lee M.D. registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Is Paul Lee M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: GOOD SAMARITAN HOSPITAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Paul Lee M.D. was last updated on July 27, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]