Individual provider Active NPI

Elizabeth Erie Lee

  • Physician Assistant
  • Chino Hills, CA
National Provider Identifier
1407515224
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
15447 Pomona Rincon Rd Unit 1159
Chino Hills, CA 91709-3194
Phone
(909) 725-8707
NPI assigned
Dec 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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 Primary

Addresses

Primary practice location

15447 Pomona Rincon Rd Unit 1159
Chino Hills, CA 91709-3194

Mailing address

15447 Pomona Rincon Rd Unit 1159
Chino Hills, CA 91709-3194

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
I20241106003616 CA Practitioner - Physician Assistant 2860926300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kevin J Pelton MD IncGroup PAC ID 3375625486, 38 clinicians

Practice addresses (Care Compare)

1700 E Cesar Chavez Ave
Suite 2200
Los Angeles, CA 90033-2476

1700 E Cesar E Chavez Ave
Suite 2200
Los Angeles, CA 90033-2476
Phone (323) 264-7600

18840 Ventura Blvd
Suite 204
Tarzana, CA 91356-6340
Phone (818) 708-3333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin J. Pelton MD, Inc. CurrentSince Aug 31, 2024 Accepting new patients
Kevin J Pelton MD Inc CurrentSince Aug 31, 2024 Accepting new patients
Kevin J. Pelton MD, Inc. Past Accepting new patients

Locations

1700 E Cesar E Chavez Ave
Ste 2200
Los Angeles, CA 90033
Phone (323) 264-7600

18840 Ventura Blvd
Ste 204
Tarzana, CA 91356
Phone (818) 708-3333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1407515224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15447 POMONA RINCON RD UNIT 1159",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15447 POMONA RINCON RD UNIT 1159",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093194",
            "telephone_number": "909-725-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ELIZABETH",
        "middle_name": "ERIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.