Individual provider Active NPI

Ho Je Lee, MD

  • Sports Medicine (Family Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1366671836
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
A112040 Issued in CA
Practice address
966 S Western Ave
Ste 201
Los Angeles, CA 90006-1015
Phone
(323) 452-0656
Fax
(562) 443-3791
NPI assigned
Jul 6, 2009
Last updated
Sep 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X A112040 CA Primary

Addresses

Primary practice location

966 S Western Ave
Ste 201
Los Angeles, CA 90006-1015

Mailing address

966 S Western Ave
Ste 201
Los Angeles, CA 90006-1015
Phone (323) 452-0656

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
I20110606000360 CA Practitioner - Family PracticePractitioner - Sports Medicine 5294861753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

966 S Western Ave
Suite 201
Los Angeles, CA 90006-1015
Phone (323) 452-0656

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112040CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Adventist Medical Center Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Lee Orthopedic Institute, a Professional Medical Corporation PastSince Aug 7, 2011 Accepting new patients
Lee Orthopedic Institute Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1366671836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE",
            "address_2": "STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061015",
            "telephone_number": "323-452-0656",
            "fax_number": "562-443-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE",
            "address_2": "STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061015",
            "telephone_number": "323-452-0656",
            "fax_number": "562-443-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HO JE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A112040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.