Jephryn Hannah Lee, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60139 Issued in CA

Practice address

3095 Old Conejo Rd Ste 200
Thousand Oaks, CA 91320-2130

Phone

(888) 367-1850

NPI assigned

Dec 31, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Irradiance Medical Group IncGroup PAC ID 2860534864, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Irradiance Medical Group Inc

  • Procedural Dermatology Physician
  • Los Angeles, CA
  • NPI 1740213198
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1336800416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 W 6TH ST APT 519",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203359",
            "telephone_number": "918-504-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202130",
            "telephone_number": "888-367-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEPHRYN",
        "middle_name": "HANNAH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-31",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Taylor Lee, CRNA
• Jaesung Lee, M.D.
• Jane F Lee, D. D. S.
• Janet Lee
• Jason Chen-Shan Lee, M.D.
• Jesse Lee
• Jonathan D. Lee, D.D.S.
• Josephine Lee, M.D.
• Lanasia Lee
• Laura Lee, PHARM.D

• Physician Assistant in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.