Active NPI
Shanshan Lee
- Family Medicine Physician
- Fresno, CA
National Provider Identifier
1194303248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A191722
- Practice address
- 1313 E Herndon Ave
Fresno, CA 93720-3306 - Phone
- (559) 450-3000
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A191722 | CA | Primary |
Addresses
Primary practice location
1313 E Herndon Ave
Fresno, CA 93720-3306
Mailing address
1313 E Herndon Ave
Fresno, CA 93720-3306
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 |
|---|---|---|---|---|
| I20240415003215 | CA | Order and Referring Only - Family Practice | 7517306277 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- shanshan.lee.1@17661.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1194303248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 E HERNDON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 E HERNDON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203306",
"telephone_number": "559-450-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SHANSHAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A191722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.