Individual provider Active NPI

Pamela Jean Lee, P.A.

  • Medical Physician Assistant
  • Long Beach, CA
National Provider Identifier
1255362984
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
WPA17020 Issued in CA
Practice address
3610 Atlantic Ave
Long Beach, CA 90807-3418
Phone
(562) 424-8814
Fax
(562) 427-2604
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PA17020 CA
Medical Physician Assistant 363AM0700X WPA17020 CA Primary
Physician Assistant 363A00000X WPA17020 CA

Addresses

Primary practice location

3610 Atlantic Ave
Long Beach, CA 90807-3418

Mailing address

PO Box 17369
Long Beach, CA 90807-7369
Phone (562) 424-8814

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
I20050224001022 CA Practitioner - Physician Assistant 5092768457 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
38.53 of 100Reported as group
Quality
20.07
Promoting interoperability
0
Improvement activities
0
Cost
75.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17020CAMDInternal Medicine Physician
WPA17020CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group, Inc. Internal Medicine CurrentSince Oct 20, 2024 Accepting new patients
Prohealth Partners a Medical Group CurrentSince Oct 20, 2024 Accepting new patients
Prohealth Partners, a Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

Organizations & group practices 6

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1255362984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17369",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908077369",
            "telephone_number": "562-424-8814",
            "fax_number": "562-427-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073418",
            "telephone_number": "562-424-8814",
            "fax_number": "562-427-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "PA17020",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "WPA17020",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "WPA17020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.