JASON LEE (DO) – Family Medicine Physician, NPI 1023691011
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
105 SPORTS MEDICINE in UT
Provider Addresses for JASON LEE (DO)
13953 S Bangerter Pkwy
Draper, UT 840205429
Phone: (385) 900-4090
Fax: (801) 365-1033
Type: Location
2295 S Foothill Dr
Salt Lake City, UT 841094000
Phone: (801) 486-3021
Fax: (801) 485-6339
Type: Location
26520 CACTUS AVE
MORENO VALLEY, CA 925553927
Phone: (951) 867-3825
Type: Location
1345 N 1020 E
AMERICAN FORK, UT 840033234
Phone:
Type: Mailing
6360 S 3000 E STE 100
SALT LAKE CITY, UT 841216924
Phone: (801) 365-1032
Fax: (801) 365-1036
Type: Location
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: 2025-08-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250819005074 | I | Family Practice | UT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84020)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Sports Medicine, Family Practice | UT | |
| - | UT | |
| Physician Assistant | GA | |
| Family Practice | UT | |
| Family Practice, Sports Medicine | CO | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | CA | |
| Certified Nurse Midwife (Cnm) | UT |
Reviews
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