Individual provider Active NPI

Kevin Lee, DPT

  • Physical Therapist
  • Pasadena, CA
National Provider Identifier
1104216183
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1017 S Fair Oaks Ave
Pasadena, CA 91105-2621
Phone
(626) 403-6200
Fax
(626) 403-2580
NPI assigned
Jan 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CA Primary

Addresses

Primary practice location

1017 S Fair Oaks Ave
Pasadena, CA 91105-2621

Mailing address

224 N Fair Oaks Ave
Suite 300
Pasadena, CA 91103-3618
Phone (626) 696-1400

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150413000021 CA Practitioner - Physical Therapist in Private Practice 2264750892 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42212CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Algos Inc., a Medical Corporation Physical Therapist CurrentSince Feb 2, 2015 Accepting new patients
Algos Inc., a Medical Corporation Physical Therapist CurrentSince Feb 2, 2015 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 16, 2019 Accepting new patients
Algos Inc., a Medical Corporation Physical Therapist Past Accepting new patients
Americare Medical Center, Inc PastSince Apr 28, 2015 Accepting new patients

Locations

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

224 N Fair Oaks Ave
Ste 300
Pasadena, CA 91103
Phone (626) 696-1451

Organizations & group practices 6

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1104216183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N FAIR OAKS AVE",
            "address_2": "SUITE 300",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033618",
            "telephone_number": "626-696-1400",
            "fax_number": "626-696-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052621",
            "telephone_number": "626-403-6200",
            "fax_number": "626-403-2580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KEVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-29",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.