Individual provider Active NPI

Sun Moon Lee, M.D.

  • Pediatrics Physician
  • Ventura, CA
National Provider Identifier
1295913523
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A107464 Issued in CA
Practice address
300 Hillmont Ave
BLDG 340, Ste 302
Ventura, CA 93003-1651
Phone
(805) 652-6255
NPI assigned
Feb 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A107464 CA Primary

Addresses

Primary practice location

300 Hillmont Ave
BLDG 340, Ste 302
Ventura, CA 93003-1651

Mailing address

800 S Victoria Ave, L4615
Vchca - Physician Services
Ventura, CA 93009-0003
Phone (805) 677-5210

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sun.lee@ventura.cernerdirect.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000555 CA Practitioner - Pediatric Medicine 6002002375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loma Linda University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

120 N Ashwood Ave
Ventura, CA 93003-1810
Phone (805) 658-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A107464CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Aug 1, 2010 Accepting new patients
Community Memorial Health System Current Accepting new patients
County of Ventura Current Accepting new patients
Community Memorial Health System CurrentSince Aug 1, 2022 Accepting new patients
Community Memorial Health System CurrentSince Aug 1, 2022 Accepting new patients
County of Ventura Current Accepting new patients
County of Ventura CurrentSince Aug 1, 2010 Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

3655 W 5th St
Oxnard, CA 93030
Phone (805) 667-3909

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

120 N Ashwood Ave
Ventura, CA 93003
Phone (805) 658-5800

800 S Victoria Ave
#L4640
Ventura, CA 93009

800 S Victoria Ave
#L4615
Ventura, CA 93009
Phone (805) 677-5181

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

3291 Loma Vista Rd
Ventura, CA 93003
Phone (805) 652-6000

Interoperability endpoints

  • Direct secure messaging: slee3514710@oc.providencedirect.org
  • Direct secure messaging: sunlee@cfh.allscriptsdirect.net

Organizations & group practices 7

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 10

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": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1295913523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S VICTORIA AVE, L4615",
            "address_2": "VCHCA - PHYSICIAN SERVICES",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930090003",
            "telephone_number": "805-677-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "address_2": "BLDG 340, STE 302",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUN",
        "middle_name": "MOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-08",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A107464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sun.lee@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave",
            "address_2": "Bldg 340, Ste 302",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.