Individual provider Active NPI

Jessica Lee, AA

  • Anesthesiologist Assistant
  • Willoughby, OH
National Provider Identifier
1265759401
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
67.000175 Issued in OH
Practice address
36000 Euclid Ave
Willoughby, OH 44094-4625
Phone
(440) 350-0832
Fax
(440) 354-7420
NPI assigned
Apr 28, 2010
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000175 OH Primary

Addresses

Primary practice location

36000 Euclid Ave
Willoughby, OH 44094-4625

Mailing address

7757 Auburn Rd Ste 15
Painesville, OH 44077-9604
Phone (440) 350-0832

Other identifiers 2

IdentifierTypeStateIssuer
3142950MedicaidOH
P01168482OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100909000346 OH Practitioner - Anesthesiology Assistant 5193840551 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

158 W Main Rd
Conneaut, OH 44030-2039

3999 Richmond Rd
Beachwood, OH 44122-6046
Phone (216) 383-0100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
67.000175OHMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Anesthesia Group, Inc CurrentSince Apr 17, 2020 Accepting new patients
University Primary Care Practices Inc CurrentSince Mar 1, 2013 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Mar 1, 2013 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Mar 1, 2012 Accepting new patients

Locations

25501 Chagrin Blvd
Beachwood, OH 44122
Phone (216) 545-4800

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

11100 Euclid Ave
Cleveland Heights, OH 44106

7757 Auburn Rd
Ste 15
Concord Township, OH 44077
Phone (440) 709-9150

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

20800 Harvard Rd
#2
Highland Hills, OH 44122
Phone (216) 358-2370

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Interoperability endpoints

  • Direct secure messaging: jlee33133@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1265759401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD STE 15",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779604",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3142950",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01168482",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.