Individual provider Active NPI

Evelyn Lee, AG-ACNP-BC

  • Acute Care Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1265807671
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
60612988 Issued in WA
Practice address
825 Eastlake Ave E
Box 358081
Seattle, WA 98109-4405
Phone
(858) 336-7432
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 60612988 WA Primary

Addresses

Primary practice location

825 Eastlake Ave E
Box 358081
Seattle, WA 98109-4405

Mailing address

825 Eastlake Ave E
Box 358081
Seattle, WA 98109-4405
Phone (858) 336-7432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20200121000545 HI Practitioner - Nurse Practitioner 5294032983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

550 S Beretania St
Honolulu, HI 96813-2496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
60612988WAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Dec 15, 2019 Accepting new patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
The Queen'S Medical Center CurrentSince Dec 15, 2019 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 405
Honolulu, HI 96813
Phone (808) 691-8866

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1265807671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "address_2": "BOX 358081",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094405",
            "telephone_number": "858-336-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "address_2": "BOX 358081",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094405",
            "telephone_number": "858-336-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EVELYN",
        "credential": "AG-ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "60612988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.