Individual provider Active NPI

Jimmy Lee, D.P.M.

  • Podiatrist
  • Arcadia, CA
National Provider Identifier
1023047347
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4470 Issued in CA
Practice address
624 W Duarte Rd Ste 105
Arcadia, CA 91007-9256
Phone
(626) 446-1740
Fax
(626) 446-6287
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4470 CA Primary

Addresses

Primary practice location

624 W Duarte Rd Ste 105
Arcadia, CA 91007-9256

Mailing address

624 W Duarte Rd Ste 105
Arcadia, CA 91007-9256
Phone (626) 446-1740

Other identifiers 2

IdentifierTypeStateIssuer
P00299462OtherCAPALMETTO GBA
4821080001OtherCANORIDIAN DME SUPP ID#

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070622000533 CA Practitioner - Podiatry 7214036854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Podiatry Group of Arcadia, IncGroup PAC ID 1153424601, 2 clinicians

Practice addresses (Care Compare)

624 W Duarte Rd
Suite 105
Arcadia, CA 91007-9256
Phone (626) 446-1740

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39
Removal of skin lesions298
Removal of nail tissue1550
Removal or shaving of skin growth521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4470CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Podiatry Group of Arcadia, Inc. Podiatrist CurrentSince Apr 1, 2006 Accepting new patients
Edmond Lee DPM, Inc. Podiatrist PastSince May 1, 2012 Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients

Locations

624 W Duarte Rd
Ste 105
Arcadia, CA 91007
Phone (626) 446-1740

650 W Duarte Rd
Ste 104
Arcadia, CA 91007
Phone (626) 446-1740

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1023047347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD STE 105",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079256",
            "telephone_number": "626-446-1740",
            "fax_number": "626-446-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD STE 105",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079256",
            "telephone_number": "626-446-1740",
            "fax_number": "626-446-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JIMMY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00299462",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN DME SUPP ID#",
            "identifier": "4821080001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.