Active NPI
Elle Lee
- Anesthesiology Physician
- San Bernardino, CA
National Provider Identifier
1356082457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 94-10952
- Practice address
- 2101 N Waterman Ave
San Bernardino, CA 92404-4836 - Phone
- (909) 883-8711
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 94-10952 | KS | Primary |
Addresses
Primary practice location
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Mailing address
1618 Orange Ave Apt 217
Redlands, CA 92373-5381
Phone (408) 694-7283
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220826002727 | KS | Order and Referring Only - Anesthesiology | 2466836333 |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3895 State Line Rd
Unit 107
Kansas City, MO 64111-3930
450 Mamaroneck Ave
Suite 201
Harrison, NY 10528-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-10952 | KS | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1356082457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1618 ORANGE AVE APT 217",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735381",
"telephone_number": "408-694-7283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 N WATERMAN AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044836",
"telephone_number": "909-883-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "KS",
"license": "94-10952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.