Individual provider Active NPI

Paul Lee, PA

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1154076693
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2223 Issued in ID
Practice address
223 16TH Ave N
Nampa, ID 83687-4058
Phone
(208) 467-7654
Fax
(208) 466-5359
NPI assigned
Feb 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2223 ID Primary

Addresses

Primary practice location

223 16TH Ave N
Nampa, ID 83687-4058

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 467-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20220321001806 ID Practitioner - Physician Assistant 8628463155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

150 2ND St
Melba, ID 83641-5199
Phone (208) 495-1011

201 S Paradise Ave
Middleton, ID 83644-5809
Phone (208) 585-0048

207 1St St S
Nampa, ID 83651-3703
Phone (208) 466-7869

300 S 23Rd St
Boise, ID 83702-9100
Phone (208) 344-3512

808 Cleveland Blvd
Caldwell, ID 83605-4168
Phone (208) 459-1025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2223IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. CurrentSince Mar 7, 2022 Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients
Community Health Clinics, Inc. Physician Assistant Past Accepting new patients

Locations

300 S 23rd St
Boise, ID 83702
Phone (208) 344-3512

400 N Allumbaugh St
Boise, ID 83704
Phone (208) 377-9180

848 S La Cassia Dr
Boise, ID 83705
Phone (208) 344-0086

108 E Idaho Ave
Homedale, ID 83628
Phone (208) 337-3189

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

201 S Paradise Ave
Middleton, ID 83644
Phone (208) 585-0048

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

156 McClure Ave
Nampa, ID 83651
Phone (208) 278-8942

223 16th Ave N
Nampa, ID 83687
Phone (208) 318-1376

Interoperability endpoints

  • Direct secure messaging: plee337555@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1154076693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 16TH AVE N",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836874058",
            "telephone_number": "208-467-7654",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PAUL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.