NPIMap

Individual provider Active NPI

Dustin John Lee, D.O.

  • Surgery Physician
  • Monterey Park, CA
National Provider Identifier
1396907432
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20A10484 Issued in CA
Practice address
600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170
Phone
(626) 281-9111
Fax
(626) 291-9499
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 390200000X 20A10484 CA
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 20A10484 CA Primary

Addresses

Primary practice location

600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170

Mailing address

600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170
Phone (626) 281-9111

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-6222

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
I20121102000153 CA Practitioner - General SurgeryPractitioner - Internal Medicine 3577713361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Internal Medicine
Education
Western University of Health Sciences College of Dental Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 N Garfield Ave
Suite 210
Monterey Park, CA 91754-1170
Phone (626) 281-9111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)19
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minimally Invasive Surgical Services, Inc., an Osteopathic Corporation Single Specialty CurrentSince Sep 2, 2012 Accepting new patients

Locations

600 N Garfield Ave
Ste 210
Monterey Park, CA 91754
Phone (626) 281-9111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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 7

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1396907432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 210",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541170",
            "telephone_number": "626-281-9111",
            "fax_number": "626-291-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 210",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541170",
            "telephone_number": "626-281-9111",
            "fax_number": "626-291-9499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-6222",
            "fax_number": "909-580-1363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DUSTIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "20A10484",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A10484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.