Active NPI
Mark Lee, M.D.
- Infectious Disease Physician
- Oakland, CA
National Provider Identifier
1184708828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- A72497
- Practice address
- 4096 Piedmont Ave
Ste 414
Oakland, CA 94611-5221 - Phone
- (510) 874-1415
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | A72497 | CA | Primary |
Addresses
Primary practice location
4096 Piedmont Ave
Ste 414
Oakland, CA 94611-5221
Mailing address
PO Box 1330
Suisun City, CA 94585-4330
Phone (510) 874-1415
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041109000643 | CA | Practitioner - Infectious Disease | 9931162153 | Practice locations: Oakland, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- New York University School of Medicine, 1997
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6345 Swainland Rd
Oakland, CA 94611-1843
Phone (510) 874-1415
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A72497 | CA | MD | Infectious Disease Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Alta Bates Summit Medical Center - Summit Campus
- General Acute Care Hospital
- Oakland, CA
- NPI 1295181477
-
dba Alta Bates Summit Medical Center - Alta Bates Campus
- General Acute Care Hospital
- Berkeley, CA
- NPI 1639523004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1184708828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1330",
"city": "SUISUN CITY",
"state": "CA",
"postal_code": "945854330",
"telephone_number": "510-874-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4096 PIEDMONT AVE",
"address_2": "STE 414",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115221",
"telephone_number": "510-874-1415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "CA",
"license": "A72497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.
- 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.