Individual provider Active NPI

Andy B. Lee, D.O.

  • Family Medicine Physician
  • Whittier, CA
National Provider Identifier
1013396274
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A15233 Issued in CA
Practice address
12291 Washington Blvd
500
Whittier, CA 90606-2500
Phone
(562) 698-0811
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A15233 CA Primary

Addresses

Primary practice location

12291 Washington Blvd
500
Whittier, CA 90606-2500

Mailing address

12291 Washington Blvd
500
Whittier, CA 90606-2500
Phone (562) 698-0811

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181128002976 CA Practitioner - Family Practice 3779827977 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9449 Imperial Hwy
Downey, CA 90242-2814
Phone (562) 461-3000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Downey Hospital, Downey, CA, CCN 050139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A15233CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 8, 2019 Accepting new patients
Pih Health Physicians CurrentSince Oct 20, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 17, 2018 Accepting new patients
Pih Health Physicians Family Medicine CurrentSince Oct 20, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Sep 17, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 8, 2019 Accepting new patients
Pih Health Physicians Family Medicine Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

3501 S Harbor Blvd
Santa Ana, CA 92704
Phone (714) 784-1658

15725 Whittier Blvd
Whittier, CA 90603
Phone (562) 448-1350

12291 Washington Blvd
Ste 500
Whittier, CA 90606
Phone (213) 698-2541

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1013396274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12291 WASHINGTON BLVD",
            "address_2": "500",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062500",
            "telephone_number": "562-698-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12291 WASHINGTON BLVD",
            "address_2": "500",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062500",
            "telephone_number": "562-698-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDY",
        "middle_name": "B.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A15233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.