ALEXANDRA MINJUNG LEE (MSN PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1104638212

ALEXANDRA MINJUNG LEE (MSN PMHNP) is a healthcare provider. based in Irvine, California. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN PMHNP. They hold a License No. 95033670 (CA). The NPI Number for ALEXANDRA MINJUNG LEE (MSN PMHNP) is 1104638212

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
ALEXANDRA MINJUNG LEE (MSN PMHNP)
NPI
1104638212
Phone
(484) 222-1952
Address
43 FRESCO
Enumeration Date
24 January 2025
Last Update Date
24 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5622790180
Graduation Year
2024 (2 years ago)
PAC ID
4385165901
Group Practice PAC ID
6507273059
Professional Enrollment ID
I20250311002525
Address ID
CA908022310LO320XXAVEX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for ALEXANDRA MINJUNG LEE (MSN PMHNP)

  • 43 FRESCO

    IRVINE, CA 926034103

    Phone: (484) 222-1952

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250311002525INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92603)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507273059View full group profile
NameSpecialtyState
Physician AssistantAZ
Physician AssistantCA
Nurse PractitionerCA
Nurse PractitionerCA
Physician AssistantCA
Clinical Social WorkerIN
Psychiatry, Geriatric PsychiatryCA
Physician AssistantCA
Physician AssistantCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Can I use this page to confirm ALEXANDRA MINJUNG LEE (MSN PMHNP)'s NPI?
Yes. ALEXANDRA MINJUNG LEE (MSN PMHNP) is listed with NPI 1104638212 in the public NPI dataset.
Is ALEXANDRA MINJUNG LEE (MSN PMHNP) still practicing?
ALEXANDRA MINJUNG LEE (MSN PMHNP) is currently listed as active in the public NPI registry.
What taxonomy line describes ALEXANDRA MINJUNG LEE (MSN PMHNP)?
For research purposes, treat ALEXANDRA MINJUNG LEE (MSN PMHNP) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for ALEXANDRA MINJUNG LEE (MSN PMHNP)?
ALEXANDRA MINJUNG LEE (MSN PMHNP)'s geographic hint is Irvine, California in our summary view.
Is the information about ALEXANDRA MINJUNG LEE (MSN PMHNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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