Individual provider Active NPI

Patricia W Lee, MD

  • Surgery Physician
  • San Jose, CA
National Provider Identifier
1073724712
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A102563 Issued in CA
Practice address
2450 Samaritan Dr
#1
San Jose, CA 95124-3912
Phone
(408) 358-1855
Fax
(408) 356-4183
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD33189 DC
Surgery Physician 208600000X 61138838 WA
Surgical Critical Care Physician 2086S0102X D0066631 MD
Surgery Physician 208600000X A102563 CA Primary

Addresses

Primary practice location

2450 Samaritan Dr
#1
San Jose, CA 95124-3912

Mailing address

2450 Samaritan Dr Ste 1
San Jose, CA 95124-3912
Phone (408) 358-1855

Other practice location 1

502 W 4th Ave
Toppenish, WA 98948-1616
Phone (509) 865-3105

Other practice location 2

1016 Tacoma Ave
Sunnyside, WA 98944-2263
Phone (509) 837-1500

Other identifiers 4

IdentifierTypeStateIssuer
19460039OtherDCCARFISRT BCBS
AY109ZOtherCAMEDICARE PTAN
413363301MedicaidMD
61543001OtherMDCAREFIRST BCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081204000289 CA Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 6204924376 Reassigns benefits to 3 organizations
I20210726002815 WA Practitioner - HospitalistPractitioner - General Surgery 6204924376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: General Surgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Physicians Group-Pannu PLLCGroup PAC ID 0345467486, 141 clinicians
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1016 Tacoma Ave
Sunnyside, WA 98944-2263
Phone (509) 837-1500

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 537-1234

250 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000

280 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

901 Nevin Ave
Richmond, CA 94801-3143
Phone (510) 307-1500

Hospital & facility affiliations

  • Eden Medical Center Hospital, Castro Valley, CA, CCN 050488
  • Kaiser Foundation Hospital-Santa Clara Hospital, Santa Clara, CA, CCN 050071
  • Kaiser Foundation Hospital-San Jose Hospital, San Jose, CA, CCN 050604

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102563CAMDOrthodontics and Dentofacial Orthopedic Dentist
A102563CAMDSurgery Physician
61138838WAMDSurgery Physician
D0066631MDMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Surgery CurrentSince Apr 26, 2010 Accepting new patients
Rural Physicians Group-Pannu PLLC Surgery CurrentSince Jul 1, 2021 Accepting new patients
Permanente Medical Group Inc Surgery Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Apr 26, 2010 Accepting new patients
Premier Physician Group, LLC Surgery Past Accepting new patients
Intensimed, LLC Past Accepting new patients

Locations

751 San Pedro Terrace Rd
Pacifica, CA 94044
Phone (650) 359-4800

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2580 Samaritan Dr
San Jose, CA 95124
Phone (408) 356-7002

700 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 851-5300

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

502 W 4th Ave
Toppenish, WA 98948
Phone (509) 575-5000

Interoperability endpoints

  • Direct secure messaging: plee228114@hisp.ehr.sutterhealth.org

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 3

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1073724712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 SAMARITAN DR STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243912",
            "telephone_number": "408-358-1855",
            "fax_number": "408-356-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SAMARITAN DR",
            "address_2": "#1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243912",
            "telephone_number": "408-358-1855",
            "fax_number": "408-356-4183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 W 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Toppenish",
            "state": "WA",
            "postal_code": "989481616",
            "country_code": "US",
            "telephone_number": "509-865-3105",
            "fax_number": "866-368-6349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 Tacoma Ave",
            "address_purpose": "LOCATION",
            "city": "Sunnyside",
            "state": "WA",
            "postal_code": "989442263",
            "country_code": "US",
            "telephone_number": "509-837-1500",
            "fax_number": "866-368-6349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "PATRICIA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "MD33189",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "61138838",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MD",
            "license": "D0066631",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A102563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARFISRT BCBS",
            "identifier": "19460039",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AY109Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413363301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "61543001",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lawrence Express Way",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.