Individual provider Active NPI

Janet K Lee, DPT

  • Physical Therapist
  • Buena Park, CA
National Provider Identifier
1174391809
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT305065 Issued in CA
Practice address
5832 Beach Blvd Ste 114
Buena Park, CA 90621-2010
Phone
(714) 707-2699
NPI assigned
Dec 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT305065 CA Primary

Addresses

Primary practice location

5832 Beach Blvd Ste 114
Buena Park, CA 90621-2010

Mailing address

12465 Lewis St Ste 101
Garden Grove, CA 92840-4658
Phone (714) 703-8477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315003114 CA Practitioner - Physical Therapist in Private Practice 3476999137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascend Physical Therapy IncGroup PAC ID 5597071860, 9 clinicians

Practice addresses (Care Compare)

5832 Beach Blvd
Suite 114
Buena Park, CA 90621-2010
Phone (714) 707-2699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT305065CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Laguna Woods Physical Therapy, Inc Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Ascend Physical Therapy, Inc Physical Therapist CurrentSince Jan 17, 2024 Accepting new patients
Innovative Management Inc CurrentSince Dec 17, 2023 Accepting new patients

Locations

12465 Lewis St
Ste 101
Garden Grove, CA 92840
Phone (714) 703-8477

24361 El Toro Rd
Ste 140
Laguna Woods, CA 92637
Phone (949) 540-7560

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1174391809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST STE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 BEACH BLVD STE 114",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212010",
            "telephone_number": "714-707-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JANET",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT305065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.