Organization Active NPI

Eric S Lee MD

  • Dermatology Physician
  • Monterey, CA
National Provider Identifier
1376253161
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ERIC S LEE MD
Practice address
284 Foam St Ste 28
Monterey, CA 93940-1486
Phone
(831) 372-3228
Fax
(831) 372-2328
NPI assigned
Dec 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Dr. Eric Lee, MDNPI 1649564410
Title
Owner
Phone
(831) 372-3228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

284 Foam St Ste 28
Monterey, CA 93940-1486

Mailing address

284 Foam St Ste 28
Monterey, CA 93940-1486
Phone (831) 372-3228

Other practice location 1

15000 Los Gatos Blvd Ste 1
Los Gatos, CA 95032-2017
Phone (408) 848-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230615003841 CA Part B Supplier - Clinic/Group Practice 8224496609 Receives reassigned benefits from 2 practitioners
Practice locations: Los Gatos, CA; Monterey, CA

National Provider Directory

National Provider Directory

Locations

15000 Los Gatos Blvd
Ste 1
Los Gatos, CA 95032
Phone (408) 358-1234

15215 National Ave
Ste 204
Los Gatos, CA 95032
Phone (408) 356-2147

284 Foam St
Unit 28
Monterey, CA 93940
Phone (831) 372-3228

284 Foam St
Ste 28
Monterey, CA 93940
Phone (408) 848-0888

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1376253161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 FOAM ST STE 28",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939401486",
            "telephone_number": "831-372-3228",
            "fax_number": "831-372-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 FOAM ST STE 28",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939401486",
            "telephone_number": "831-372-3228",
            "fax_number": "831-372-2328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15000 Los Gatos Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950322017",
            "country_code": "US",
            "telephone_number": "408-848-0888",
            "fax_number": "408-848-0999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ERIC S LEE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-372-3228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.