Individual provider Active NPI

Ray W Lee, MD

  • Emergency Medicine Physician
  • Moss Beach, CA
National Provider Identifier
1205913969
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G66832 Issued in CA
Practice address
600 Marine Blvd
Moss Beach, CA 94038-9641
Phone
(650) 563-7107
NPI assigned
Nov 1, 2006
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101232526 VA
Emergency Medicine Physician 207P00000X G66832 CA Primary

Addresses

Primary practice location

600 Marine Blvd
Moss Beach, CA 94038-9641

Mailing address

17055 Grandee Way
San Diego, CA 92128-2125
Phone (703) 282-0236

Other identifiers 2

IdentifierTypeStateIssuer
930123436OtherVARRMCR
5878501MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101232526VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 17, 2015 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Emergency Medicine CurrentSince Jan 17, 2015 Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Dec 1, 2022 Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Dec 1, 2022 Accepting new patients
Foothill Emergency Medical Associates, Inc Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients

Locations

1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503

600 Marine Blvd
Moss Beach, CA 94038
Phone (650) 563-7100

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1205913969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17055 GRANDEE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282125",
            "telephone_number": "703-282-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARINE BLVD",
            "city": "MOSS BEACH",
            "state": "CA",
            "postal_code": "940389641",
            "telephone_number": "650-563-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RAY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101232526",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G66832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "930123436",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5878501",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moss Beach, CA

Sources for this page

Verify at the official NPI Registry.