Individual provider Active NPI

Mayge Lee

  • Physician Assistant
  • San Juan Capistrano, CA
National Provider Identifier
1043061161
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64684 Issued in CA
Practice address
30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Phone
(949) 240-2272
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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 64684 CA Primary

Addresses

Primary practice location

30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304

Mailing address

30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Phone (949) 240-2272

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
I20250211003427 CA Order and Referring Only - Family PracticePractitioner - Family Practice 9830629476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64684CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: maygelee@chcca.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1043061161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30300 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751304",
            "telephone_number": "949-240-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30300 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751304",
            "telephone_number": "949-240-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MAYGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

Verify at the official NPI Registry.