Individual provider Active NPI

Sandra L. Lee, PA

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1376566968
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17987 Issued in CA
Practice address
4411 E. Cesar Chavez Blvd # 319
Fresno, CA 92702-9370
Phone
(559) 432-8300
Fax
(559) 432-9083
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17987 CA Primary

Addresses

Primary practice location

4411 E. Cesar Chavez Blvd # 319
Fresno, CA 92702-9370

Mailing address

7355 N Palm Ave Ste 110
Fresno, CA 93711-5770
Phone (559) 271-6301

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000640 CA Practitioner - Physician Assistant 4587688841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Term Care Medical Group, IncGroup PAC ID 9032016068, 37 clinicians

Practice addresses (Care Compare)

2335 E Kashian LN
Fresno, CA 93701-2234

7355 N Palm Ave
Fresno, CA 93711-5770

925 N Cornelia Ave
Fresno, CA 93706-1031
Phone (559) 275-4785

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17987CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Oct 1, 2013 Accepting new patients
Wai S. Lee MD, Professional Corporation Past Accepting new patients

Locations

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

4770 W Herndon Ave
Fresno, CA 93722
Phone (559) 271-6300

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1376566968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 N PALM AVE STE 110",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115770",
            "telephone_number": "559-271-6301",
            "fax_number": "559-271-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 E. CESAR CHAVEZ BLVD # 319",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "927029370",
            "telephone_number": "559-432-8300",
            "fax_number": "559-432-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANDRA",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.