Young Tae Lee, PNHNP - Medicare Nurse Practitioner in Agoura Hills, CA

Young Tae Lee, PNHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Agoura Hills, California. His current practice location is 30423 Canwood St Ste 123, Agoura Hills, California. You can reach out to his office (for appointments etc.) via phone at (818) 385-1219.

Young Tae Lee is licensed to practice in California (license number 95019749) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225780562.

Contact Information

Young Tae Lee, PNHNP
30423 Canwood St Ste 123,
Agoura Hills, CA 91301-4314
(818) 385-1219
(818) 385-1600



Provider's Profile

Full NameYoung Tae Lee
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location30423 Canwood St Ste 123, Agoura Hills, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1225780562
  • Provider Enumeration Date: 01/18/2022
  • Last Update Date: 02/22/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8022486679
  • Enrollment ID: I20221201002402

Medical Identifiers

Medical identifiers for Young Tae Lee such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225780562NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 95019749 (California)Primary
163WP0808XRegistered Nurse - Psychiatric/mental Health 95158737 (California)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Young Tae Lee allows following entities to bill medicare on his behalf.
Entity NameRobert P Kahn-rose Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407936784
PECOS PAC ID: 6305843939
Enrollment ID: O20110310000874

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Young Tae Lee is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Young Tae Lee, PNHNP
30423 Canwood St Ste 123,
Agoura Hills, CA 91301-4314

Ph: (818) 385-1219
Young Tae Lee, PNHNP
30423 Canwood St Ste 123,
Agoura Hills, CA 91301-4314

Ph: (818) 385-1219

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Nurse Practitioner Nurses in Agoura Hills, CA

Aryan Jamali,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 30423 Canwood St Ste 225, Agoura Hills, CA 91301
Phone: 818-871-9518    Fax: 818-871-9521
Collette Lee King, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 29525 Canwood St, Suite 300, Agoura Hills, CA 91301
Phone: 818-706-2477    Fax: 818-706-2368
Jennifer Rusnanto Ng, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 29525 Canwood St Ste 200, Agoura Hills, CA 91301
Phone: 818-699-6553    
Eunice Fernandez, MSN, NP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 5623 Kanan Rd, Agoura Hills, CA 91301
Phone: 818-991-5522    
Joeline Ellison, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 29343 Wagon Rd, Agoura Hills, CA 91301
Phone: 310-367-6210    
Yana Tregubova Khilkevich, FNP-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 28720 Roadside Dr # 333, Agoura Hills, CA 91301
Phone: 818-267-4154    

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