Individual provider Active NPI

Loretta Y Lee, AUD

  • Audiologist
  • Anaheim, CA
National Provider Identifier
1083981591
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2828 Issued in CA
Practice address
3460 E la Palma Ave
Anaheim, CA 92806-2020
Phone
(714) 644-2073
NPI assigned
Nov 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147-001026 IL
Audiologist 231H00000X AU2828 CA Primary

Addresses

Primary practice location

3460 E la Palma Ave
Anaheim, CA 92806-2020

Mailing address

3460 E la Palma Ave
Anaheim, CA 92806-2020
Phone (714) 644-2073

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120518000080 CA Practitioner - Qualified Audiologist 4880857499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

3430 E la Palma Ave
Anaheim, CA 92806-2020
Phone (888) 988-2800

3460 E la Palma Ave
Anaheim, CA 92806-2020
Phone (714) 644-2010

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU2828CAMDAudiologist
147-001026ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 4, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 4, 2016 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

3460 E La Palma Ave
Anaheim, CA 92806
Phone (714) 644-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1083981591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062020",
            "telephone_number": "714-644-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062020",
            "telephone_number": "714-644-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LORETTA",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-001026",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.