Carolyn Lee, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA57103 Issued in CA

Practice address

675 S Arroyo Pkwy Ste 200
Pasadena, CA 91105-3215

Phone

(626) 585-4120

NPI assigned

Oct 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Rosemead, CA
  • NPI 1942787114
  NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1184266207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY STE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053215",
            "telephone_number": "626-585-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY STE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053215",
            "telephone_number": "626-585-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CAROLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2024-05-07",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barbara Raven Lee, LCSW
• Brenna Lee
• Bretton Lee, CCC-SLP
• Brian H Lee, OTR/L
• Caroline Chaewon Lee, MA, LMFT
• Cathy Damee Lee
• CHI Hye Lee, MD
• Chynna Drake Lee, PSY.D.
• Clement Kin-Man Lee, N.D.
• Crystal Lee

• Physician Assistant in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.