Kristen Kyunghyun Lee

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8149 Issued in AZ

Practice address

815 E Warner Rd Ste 104
Chandler, AZ 85225-1057

Phone

(623) 466-6350

NPI assigned

Mar 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristen.lee.1@19654.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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group
• Brian S Page DO LLC

  • Pain Medicine Physician
  • Glendale, AZ
  • NPI 1821282666
  Medicare reassignment
• Brian S Page DO LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1205645447
  NPD

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1457812554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E WARNER RD STE 104",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E WARNER RD STE 104",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251057",
            "telephone_number": "623-466-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KRISTEN",
        "middle_name": "KYUNGHYUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8149",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lee
• Eunjung Lee
• Janelle Unhae Lee, D.D.S.
• Jay Lee
• June Anthony Lee, APRN
• Kyesub Lee, L.AC.
• Stephanie H. Lee, O.D.
• Stephen Junho Lee, N.M.D.
• Sue S Lee, MA-CCC, SLP
• Yoona Kim Lee, PHARMD

• Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.