Individual provider Active NPI

Michelle Lee, PA-C

  • Physician Assistant
  • Grapevine, TX
National Provider Identifier
1275939373
Registry record updated Dec 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09580 Issued in TX
Practice address
2355 E Grapevine Mills Cir
Grapevine, TX 76051-2047
Phone
(972) 539-6330
NPI assigned
Nov 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2014

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 PA09580 TX Primary

Addresses

Primary practice location

2355 E Grapevine Mills Cir
Grapevine, TX 76051-2047

Mailing address

2355 E Grapevine Mills Cir
Grapevine, TX 76051-2047
Phone (972) 539-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180319002334 NY Practitioner - Physician Assistant 9739441320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

138 Delancey St
New York, NY 10002-3325
Phone (212) 609-2541

14 W 14TH St
New York, NY 10011-7524
Phone (212) 390-0558

2025 Broadway
New York, NY 10023-5016
Phone (212) 390-8812

216 E 14TH St
New York, NY 10003-4105

331 6TH Ave
New York, NY 10014-4403
Phone (212) 219-2659

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

37 W 23Rd St
New York, NY 10010-5389
Phone (646) 596-9267

654 Broadway
New York, NY 10012-2327
Phone (646) 647-1251

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA09580TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Feb 3, 2018 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 3, 2018 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Fl 13
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: michelle.lee.1@2983.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418428800000",
    "number": "1275939373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 E GRAPEVINE MILLS CIR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760512047",
            "telephone_number": "972-539-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 E GRAPEVINE MILLS CIR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760512047",
            "telephone_number": "972-539-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.