NPIMap

Individual provider Active NPI

Grace Moore Lee, N.P.

  • Family Nurse Practitioner
  • Daly City, CA
National Provider Identifier
1356758635
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000963 Issued in CA
Practice address
380 90TH St
Daly City, CA 94015-1807
Phone
(650) 301-8600
Fax
(650) 298-6880
NPI assigned
Jul 17, 2014
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000963 CA Primary

Addresses

Primary practice location

380 90TH St
Daly City, CA 94015-1807

Mailing address

380 90TH St
Daly City, CA 94015-1807
Phone (650) 301-8600

Other names 1

  • Grace Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151015000047 CA Practitioner - Nurse Practitioner 3375867518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

380 90TH St
Daly City, CA 94015-1807
Phone (650) 573-2222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Sep 1, 2015 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Sep 1, 2015 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Aug 1, 2017 Accepting new patients

Locations

380 90th St
Daly City, CA 94015
Phone (650) 301-8600

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: glee19219@smch.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1356758635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 90TH ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151807",
            "telephone_number": "650-301-8600",
            "fax_number": "650-298-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 90TH ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151807",
            "telephone_number": "650-301-8600",
            "fax_number": "650-298-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GRACE",
        "middle_name": "MOORE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "MOORE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.