Active NPI
Larisse K Lee, M.D.
- Vascular Surgery Physician
- Sherman Oaks, CA
National Provider Identifier
1124282645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 239830
- Practice address
- 4955 Van Nuys Blvd
Suite 704
Sherman Oaks, CA 91403 - Phone
- (818) 325-0400
- Fax
- (818) 325-0404
- NPI assigned
- Jul 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 239830 | NY | Primary |
Addresses
Primary practice location
4955 Van Nuys Blvd
Suite 704
Sherman Oaks, CA 91403
Mailing address
4955 Van Nuys Blvd
Suite 704
Sherman Oaks, CA 91403
Phone (818) 325-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A117214 | Other | CA | MEDICAL BOARD STATE LICENSE |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120113000336 | CA | Practitioner - Vascular Surgery | 4183790090 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Stanford University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4955 Van Nuys Blvd
Suite 704
Sherman Oaks, CA 91403-1819
Phone (818) 325-0400
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.06 of 100
- Quality
- 84.34
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 609 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larisse Lee MD PC | Vascular Surgery | Current | Accepting new patients |
| Addison ASC LLC | Past | Accepting new patients | |
| Slrhc Faculty Practice | Vascular Surgery | Past | Accepting new patients |
| St Lukes Roosevelt Community Care | Past | Accepting new patients | |
| Valley Presbyterian Hospital | Past | Accepting new patients |
Locations
4955 Van Nuys Blvd
Ste 301
Sherman Oaks, CA 91403
Phone (818) 325-0400
4955 Van Nuys Blvd
Ste 704
Van Nuys, CA 91403
Phone (818) 325-0400
Interoperability endpoints
- https://api.platform.athenahealth.com/5843/brand/1/csg/1/fhir/r4
- larisse.lee.1@5843.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Ambulatory Surgical Clinic/Center
- Sherman Oaks, CA
- NPI 1467903716
-
- General Acute Care Hospital
- Van Nuys, CA
- NPI 1578529285
-
- Internal Medicine Physician
- New York, NY
- NPI 1740469246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1124282645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4955 VAN NUYS BLVD",
"address_2": "SUITE 704",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91403",
"telephone_number": "818-325-0400",
"fax_number": "818-325-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4955 VAN NUYS BLVD",
"address_2": "SUITE 704",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91403",
"telephone_number": "818-325-0400",
"fax_number": "818-325-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "LARISSE",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-14",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "NY",
"license": "239830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD STATE LICENSE",
"identifier": "A117214",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.