Jaesung Lee, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G64716 Issued in CA

Practice address

301 S Moorpark Rd
Thousand Oaks, CA 91361-1008

Phone

(805) 379-9646

Fax

(805) 379-0611

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Otolaryngology

Education

Loma Linda University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

West Coast Ear, Nose and ThroatGroup PAC ID 9638352503, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Johns Regional Medical Center Hospital, Oxnard, CA, CCN 050082
• Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

Merit-based Incentive Payment System (MIPS)

Final score

90.26 of 100Reported as group

Quality

80.51

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaesung.lee.1@25176.direct.athenahealth.com

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.

• Bass Medical Group

  • Obstetrics & Gynecology Physician
  • Walnut Creek, CA
  • NPI 1174253405

  Otolaryngology

  Medicare reassignment Care Compare group NPD
• West Coast Ear Nose and Throat

  • Specialist
  • Simi Valley, CA
  • NPI 1588868863
  Medicare reassignment Care Compare group NPD
• Jaesung Lee

  • Specialist
  • Thousand Oaks, CA
  • NPI 1609072503
  NPD (past) Authorized official
• Bass Medical Group

  • Orthopaedic Surgery Physician
  • San Ramon, CA
  • NPI 1467329904
  NPD
• Bass Medical Group

  • Specialist
  • Walnut Creek, CA
  • NPI 1154401941
  NPD (past)
• Bass Medical Group

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1326409343
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • General Acute Care Hospital
  • Oxnard, CA
  • NPI 1073665360
  Care Compare affiliation
• Los Robles Regional Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1306890389
  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1376550715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2876 SYCAMORE DR",
            "address_2": "SUITE 303",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651530",
            "telephone_number": "805-527-7320",
            "fax_number": "805-527-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MOORPARK RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611008",
            "telephone_number": "805-379-9646",
            "fax_number": "805-379-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAESUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G64716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00957561",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G64716",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Corinne Lee, ATC
• Christopher Lee
• David Yong Lee, L.AC.
• Eugene Lee
• Gloria Taylor Lee, CRNA
• Jane F Lee, D. D. S.
• Janet Lee
• Jason Chen-Shan Lee, M.D.
• Jephryn Hannah Lee, PA
• Jesse Lee

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.