Individual provider Active NPI

Scott Ken Lee, PT, DPT, OCS, ATC

  • Orthopedic Physical Therapist
  • Beverly Hills, CA
National Provider Identifier
1447647912
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT297161 Issued in CA
Practice address
415 N Crescent Dr Ste 130
Beverly Hills, CA 90210-6816
Phone
(626) 710-0660
NPI assigned
Apr 22, 2015
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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 Program 390200000X NU
Orthopedic Physical Therapist 2251X0800X PT297161 CA Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

415 N Crescent Dr Ste 130
Beverly Hills, CA 90210-6816

Mailing address

215 La Paloma Ave
Alhambra, CA 91801-3033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023000350 CA Practitioner - Physical Therapist in Private Practice 1254663388 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT297161CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BSP Physical Therapy Inc Orthopedic CurrentSince Sep 1, 2020 Accepting new patients
Rehab Specialists, Inc Orthopedic CurrentSince Oct 1, 2021 Accepting new patients
California Luna Care Physical Therapy PC Orthopedic CurrentSince May 17, 2021 Accepting new patients
California State University Long Beach Orthopedic CurrentSince Sep 1, 2019 Accepting new patients
Adi Rehab, Incorporated Orthopedic PastSince Nov 24, 2019 Accepting new patients

Locations

415 N Crescent Dr
Ste 130
Beverly Hills, CA 90210
Phone (310) 273-0677

500 E Olive Ave
Ste 325
Burbank, CA 91501
Phone (818) 955-5786

1250 N Bellflower Blvd
Rm 105
Long Beach, CA 90840
Phone (562) 985-8286

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

2730 Wilshire Blvd
Ste 533
Santa Monica, CA 90403
Phone (310) 273-0870

10635 Santa Monica Blvd
Ste 165
West Los Angeles, CA 90025
Phone 3102730877143

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1447647912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 LA PALOMA AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CRESCENT DR STE 130",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902106816",
            "telephone_number": "626-710-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SCOTT",
        "middle_name": "KEN",
        "credential": "PT, DPT, OCS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT297161",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.