Active NPI
Moonny Lee, PA-C
- Physician Assistant
- Sacramento, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17025
- Practice address
- 1201 Alhambra Blvd Ste 400
Sacramento, CA 95816-5243 - Phone
- (916) 733-5098
- NPI assigned
- Mar 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17025 | CA | Primary |
Addresses
Primary practice location
1201 Alhambra Blvd Ste 400
Sacramento, CA 95816-5243
Mailing address
10470 Old Placerville Rd
Sacramento, CA 95827-2539
Phone (800) 470-0071
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2060 Harbison Dr
Suite D
Vacaville, CA 95687-3907
Phone (800) 972-5547
2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600
2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731
2800 L St
Sacramento, CA 95816-5616
4647 2ND St
Suite 130
Davis, CA 95618-9419
Phone (800) 972-5547
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Valley Medical Foundation | Physician Assistant | Current | Accepting new patients |
| River City Medical Group, Inc. | Past | Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients |
Locations
4647 2nd St
Ste 130
Davis, CA 95618
2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731
2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398
10470 Old Placerville Rd
Sacramento, CA 95827
Phone (916) 854-6666
1201 Alhambra Blvd
Ste 400
Sacramento, CA 95816
Phone (916) 733-5090
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
Interoperability endpoints
- mlee153074@hisp.ehr.sutterhealth.org
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.
-
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
-
- Durable Medical Equipment & Medical Supplies
- Tracy, CA
- NPI 1720930712
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1952327256
Physician Assistant
-
- Family Medicine Physician
- Sacramento, CA
- NPI 1083722516
-
- Clinical Medical Laboratory
- Berkeley, CA
- NPI 1831381623
-
- Family Medicine Physician
- Orinda, CA
- NPI 1871538769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1124088893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 OLD PLACERVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958272539",
"telephone_number": "800-470-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 ALHAMBRA BLVD STE 400",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165243",
"telephone_number": "916-733-5098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MOONNY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-25",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.