Individual provider Active NPI

Don W Lee, M.D.

  • Interventional Cardiology Physician
  • Glendale, CA
National Provider Identifier
1104806421
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A34051 Issued in CA
Practice address
710 S Central Ave
Suite 210
Glendale, CA 91204-4609
Phone
(818) 247-0160
Fax
(818) 247-4628
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X A34051 CA Primary

Addresses

Primary practice location

710 S Central Ave
Suite 210
Glendale, CA 91204-4609

Mailing address

710 S Central Ave
Suite 300
Glendale, CA 91204-4609
Phone (818) 247-0160

Other identifiers 1

IdentifierTypeStateIssuer
00A340510MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070508000755 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9638128184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Don W Lee M D a Medical CorporationGroup PAC ID 7911956461, 3 clinicians

Practice addresses (Care Compare)

710 S Central Ave
Suite 200
Glendale, CA 91204-4646
Phone (818) 247-0160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A34051CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Don W Lee, MD, a Medical Corporation Interventional Cardiology CurrentSince May 17, 1989 Accepting new patients
Hollywood Heart and Vascular Group, a Medical Corporation PastSince Feb 1, 2007 Accepting new patients
TLC Urgent Care PastSince Jan 23, 2017 Accepting new patients
Sumita Paul MD a Medical Corporation PastSince Aug 16, 2024 Accepting new patients

Locations

710 S Central Ave
Ste 200
Glendale, CA 91204
Phone (818) 247-0160

710 S Central Ave
Ste 300
Glendale, CA 91204
Phone (323) 644-9504

710 S Central Ave
Ste 210
Glendale, CA 91204
Phone (818) 247-0160

1510 S Central Ave
Ste 150
Glendale, CA 91204
Phone (818) 247-0160

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14621/brand/2/csg/1/fhir/r4

Organizations & group practices 4

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1104806421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE",
            "address_2": "SUITE 300",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044609",
            "telephone_number": "818-247-0160",
            "fax_number": "818-247-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE",
            "address_2": "SUITE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044609",
            "telephone_number": "818-247-0160",
            "fax_number": "818-247-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DON",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A34051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A340510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.