Individual provider Active NPI

Rachel Minjoo Lee, FNP

  • Family Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1124865530
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030995 Issued in CA
Practice address
625 S Fair Oaks Ave Ste 215
Pasadena, CA 91105-2613
Phone
(626) 793-4139
Fax
(626) 793-4324
NPI assigned
Jul 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030995 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 215
Pasadena, CA 91105-2613

Mailing address

PO Box 80011
City of Industry, CA 91716-8011
Phone (626) 793-2885

Other identifiers 2

IdentifierTypeStateIssuer
NP95030995OtherCABRN
2024063572OtherCAANCC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828004025 CA Practitioner - Nurse Practitioner 2769921287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothill Cardiology Medical Group IncGroup PAC ID 8527049261, 36 clinicians

Practice addresses (Care Compare)

625 S Fair Oaks Ave
Suite 215
Pasadena, CA 91105-2613
Phone (626) 793-4139

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95030995CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothill Cardiology Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

625 S Fair Oaks Ave
Ste 215
Pasadena, CA 91105
Phone (626) 793-4139

Interoperability endpoints

  • Direct secure messaging: rlee514313@direct.cshs.org
  • Direct secure messaging: rachel.lee.p166@direct.healthcarepartners.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1124865530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80011",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168011",
            "telephone_number": "626-793-2885",
            "fax_number": "626-793-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 215",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052613",
            "telephone_number": "626-793-4139",
            "fax_number": "626-793-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RACHEL",
        "middle_name": "MINJOO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRN",
            "identifier": "NP95030995",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2024063572",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.