Active NPI
Jerome Lee, M.D.
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- License
- A114709
- Practice address
- 11301 Wilshire Blvd
Physical Medicine & Rehabilitation (W117)
Los Angeles, CA 90073-1003 - Phone
- (310) 478-3711
- NPI assigned
- Jan 13, 2009
- 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 |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | A114709 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd
Physical Medicine & Rehabilitation (W117)
Los Angeles, CA 90073-1003
Mailing address
11301 Wilshire Blvd
Physical Medicine & Rehabilitation (W117)
Los Angeles, CA 90073-1003
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A114709 | CA | MD | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| Precision Occupational Medical Group, Inc. | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Compre Hensive Primary Care Medical Associates, Inc | Past | Accepting new patients |
Locations
7774 Cherry Ave
Fontana, CA 92336
Phone (909) 355-1296
1225 W 190th St
Ste 425
Gardena, CA 90248
Phone (310) 527-7996
200 Muir Rd
Martinez, CA 94553
Phone (925) 313-4600
8520 Archibald Ave
Ste B
Rancho Cucamonga, CA 91730
Phone (909) 481-3909
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
1809 E Dyer Rd
Ste 311
Santa Ana, CA 92705
Phone (949) 863-0022
1809 E Dyer Rd
Ste 313
Santa Ana, CA 92705
Phone (949) 975-1900
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
1321 W Garvey Ave N
West Covina, CA 91790
Phone (626) 337-6335
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
- Physical Medicine & Rehabilitation Physician
- West Covina, CA
- NPI 1821290024
-
- Internal Medicine Physician
- Stockton, CA
- NPI 1548343510
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
-
- Family Medicine Physician
- Fontana, CA
- NPI 1982786620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1245477280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"address_2": "PHYSICAL MEDICINE & REHABILITATION (W117)",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"address_2": "PHYSICAL MEDICINE & REHABILITATION (W117)",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-478-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEROME",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-13",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "CA",
"license": "A114709",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "200 Muir Rd",
"city": "Martinez",
"state": "CA",
"country_code": "US",
"postal_code": "945534614",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.