JAEWON LEE (CNP) – Family Nurse Practitioner, NPI 1558815522
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for JAEWON LEE (CNP)
109 US Highway 66 E
Tell City, IN 475862755
Phone: (812) 547-3447
Fax: (812) 547-9543
Type: Location
1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States
ROCHESTER, MN 559050001
Phone: (507) 284-2511
Type: Mailing
1217 BONITA ST
GRANTS, NM 870202103
Phone: (052) 872-9585
Fax: (505) 443-8342
Type: Mailing
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: 2023-11-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210907002473 | I | Nurse Practitioner | TX | TBD |
| I20231103001864 | I | Nurse Practitioner | NM | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 17 | 16 | $0 |
Insurance plans in this area (ZIP 47586)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NM | |
| Neuropsychiatry, Clinical Psychologist | NM | |
| Nurse Practitioner | NM | |
| - | NM | |
| - | CA | |
| - | NM | |
| - | NM | |
| Nurse Practitioner | ID | |
| Clinical Social Worker | NM | |
| Family Practice | NM |
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