Individual provider Active NPI

Gordon Y Lee, PA-C

  • Physician Assistant
  • Albany, CA
National Provider Identifier
1033432604
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20598 Issued in CA
Practice address
500 San Pablo Ave
Albany, CA 94706-1103
Phone
(510) 204-8130
Fax
(510) 524-0861
NPI assigned
Mar 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20598 CA Primary

Addresses

Primary practice location

500 San Pablo Ave
Albany, CA 94706-1103

Mailing address

500 San Pablo Ave
Albany, CA 94706-1103
Phone (510) 204-8130

Other practice location 1

1107 West Poplar Avenue
Porterville, CA 93257-5839
Phone (559) 781-7242

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000846 CA Practitioner - Physician Assistant 8527199066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3100 Telegraph Ave
Oakland, CA 94609-3239
Phone (510) 204-8290

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

365 Hawthorne Ave
Oakland, CA 94609-3115

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Concord, CA, CCN 057004
  • BLC Homehealth Inc Home health agency, San Leandro, CA, CCN 053137
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20598CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Feb 5, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Feb 5, 2018 Accepting new patients
Family Healthcare Network CurrentSince Mar 19, 2010 Accepting new patients
Family Healthcare Network CurrentSince Mar 19, 2010 Accepting new patients

Locations

500 San Pablo Ave
Berkeley, CA 94706
Phone (510) 204-8130

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3687 Mt Diablo Blvd
Ste 200
Lafayette, CA 94549
Phone (510) 204-6660

1107 W Poplar Ave
Porterville, CA 93257
Phone (559) 781-7242

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

Interoperability endpoints

  • Direct secure messaging: glee388681@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 4

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": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1033432604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061103",
            "telephone_number": "510-204-8130",
            "fax_number": "510-524-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061103",
            "telephone_number": "510-204-8130",
            "fax_number": "510-524-0861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 West Poplar Avenue",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "932575839",
            "country_code": "US",
            "telephone_number": "559-781-7242",
            "fax_number": "559-793-3542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "GORDON",
        "middle_name": "Y",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-10",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, CA

Sources for this page

Verify at the official NPI Registry.