Individual provider Active NPI

Hai Le, M.D.

  • Family Medicine Physician
  • Cameron Park, CA
National Provider Identifier
1184004772
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A151243 Issued in CA
Practice address
3100 Ponte Morino Dr
Cameron Park, CA 95682-7432
Phone
(530) 621-7700
Fax
(530) 621-7713
NPI assigned
Jun 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A151243 CA Primary

Addresses

Primary practice location

3100 Ponte Morino Dr
Cameron Park, CA 95682-7432

Mailing address

3100 Ponte Morino Dr
Cameron Park, CA 95682-7432
Phone (530) 621-7700

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
I20251030002557 CA Practitioner - Family Practice 9133460801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luxvitality Medical CorpGroup PAC ID 3971004680, 4 clinicians

Practice addresses (Care Compare)

3635 Bradshaw Rd
Suite B
Sacramento, CA 95827-3277
Phone (916) 447-0661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151243CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luxvitality Medical Corp CurrentSince Aug 10, 2025 Accepting new patients
El Dorado County Community Health Center Past Accepting new patients

Locations

3635 Bradshaw Rd
Ste B
Sacramento, CA 95827
Phone (916) 368-1500

Interoperability endpoints

  • Direct secure messaging: hai.le@edchc.eclinicaldirectplus.com

Organizations & group practices 2

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 2

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1184004772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 PONTE MORINO DR",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956827432",
            "telephone_number": "530-621-7700",
            "fax_number": "530-621-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PONTE MORINO DR",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956827432",
            "telephone_number": "530-621-7700",
            "fax_number": "530-621-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "HAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A151243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron Park, CA

Sources for this page

Verify at the official NPI Registry.