Individual provider Active NPI

Caitlyn Lee

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1225990575
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA67217 Issued in CA
Practice address
4735 Hamilton Ave Unit 80
San Jose, CA 95130-1799
Phone
(669) 282-6047
NPI assigned
Nov 25, 2025
Last updated
Dec 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA67217 CA Primary

Addresses

Primary practice location

4735 Hamilton Ave Unit 80
San Jose, CA 95130-1799

Mailing address

1375 Blossom Hill Rd Ste 49
San Jose, CA 95118-3806
Phone (408) 645-7073

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260323002566 CA Order and Referring Only - Physician Assistant 6305320888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA67217CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Action Urgent Care Inc CurrentSince Dec 7, 2025 Accepting new patients

Locations

1375 Blossom Hill Rd
Ste 49
San Jose, CA 95118
Phone (408) 440-8335

4735 Hamilton Ave
Unit 80
San Jose, CA 95130
Phone (408) 506-5194

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1225990575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 BLOSSOM HILL RD STE 49",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951183806",
            "telephone_number": "408-645-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 HAMILTON AVE UNIT 80",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951301799",
            "telephone_number": "669-282-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.