Individual provider Active NPI

Peter C Lee, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
National Provider Identifier
1063508786
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A047846 Issued in CA
Practice address
4805 Rosewood Ave
Los Angeles, CA 90004-2509
Phone
(323) 469-1000
Fax
(323) 469-1101
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A047846 CA Primary

Addresses

Primary practice location

4805 Rosewood Ave
Los Angeles, CA 90004-2509

Mailing address

4805 Rosewood Ave
Los Angeles, CA 90004-2509
Phone (323) 469-1000

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
I20041201000985 CA Practitioner - Physical Medicine and Rehabilitation 5294799607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4805 Rosewood Ave
Los Angeles, CA 90004-2509
Phone (323) 469-1000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A047846CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter C Lee MD AMC CurrentSince Jun 28, 2003 Accepting new patients
Advocate Health and Hospitals Corporation PastSince Jun 28, 2003 Accepting new patients

Locations

3030 W Olympic Blvd
Ste 213
Los Angeles, CA 90006
Phone (213) 277-1333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1063508786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 ROSEWOOD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042509",
            "telephone_number": "323-469-1000",
            "fax_number": "323-469-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 ROSEWOOD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042509",
            "telephone_number": "323-469-1000",
            "fax_number": "323-469-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PETER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A047846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.