Individual provider Active NPI

Jason F Lee, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Burbank, CA
National Provider Identifier
1164786042
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
A134450 Issued in CA
Practice address
4323 W Riverside Dr
Burbank, CA 91505-4044
Phone
(818) 556-2700
NPI assigned
Jun 26, 2012
Last updated
Oct 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A134450 CA
Geriatric Medicine (Family Medicine) Physician 207QG0300X A134450 CA Primary

Addresses

Primary practice location

4323 W Riverside Dr
Burbank, CA 91505-4044

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 301-8714

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316002653 CA Practitioner - Family PracticePractitioner - Geriatric Medicine 4587960513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 Flower St
Glendale, CA 91201-3007
Phone (818) 659-5000

4323 W Riverside Dr
Burbank, CA 91505-4044
Phone (818) 556-2700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134450CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 7, 2016 Accepting new patients
Regents of the University of California Family Medicine CurrentSince Feb 7, 2016 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

4323 W Riverside Dr
Burbank, CA 91505
Phone (818) 556-2700

1000 Flower St
Glendale, CA 91201
Phone (818) 659-5000

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 59755
Los Angeles, CA 90074

Interoperability endpoints

  • Direct secure messaging: jlee382646@direct.uclahealth.org

Organizations & group practices 3

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.

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1164786042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8714",
            "fax_number": "310-301-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 W RIVERSIDE DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054044",
            "telephone_number": "818-556-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A134450",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A134450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.