Bryan Xiao-Qiu Lee, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A91137 Issued in CA

Practice address

250 W Bonita Ave
Suite 160
Pomona, CA 91767-1863

Phone

(909) 593-1002

Fax

(909) 593-1004

NPI assigned

Dec 11, 2006

Last updated

Apr 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional Pain ManagementAlso: Anesthesiology

Education

University of California, San Diego School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bryan X Lee MD a Professional Medical CorporationGroup PAC ID 0941478960, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Bryan X Lee MD a Professional Medical Corporation

  dba Southern California Center for Pain Management

  • Interventional Pain Medicine Physician
  • Pomona, CA
  • NPI 1144526773
  Medicare reassignment Care Compare group NPD Authorized official
• Chino Medical Group, Inc

  dba My Family Medical Group

  • Health Maintenance Organization
  • Chino, CA
  • NPI 1790730786
  NPD (past)
• Chino Premier Surgery Center Limited Partnership

  • Ambulatory Surgical Clinic/Center
  • Chino, CA
  • NPI 1457820466
  NPD (past)
• Four Seasons Surgery Centers of Ontario, LP

  • Ambulatory Surgical Clinic/Center
  • Ontario, CA
  • NPI 1215019625
  NPD (past)
• Glendale Adventist Medical Center

  dba Adventist Health Glendale

  • Skilled Nursing Facility
  • Glendale, CA
  • NPI 1114916293
  NPD (past)
• Karin C Li MD a Prof Med Corp

  • Internal Medicine Physician
  • Chino, CA
  • NPI 1801157896
  NPD (past)
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111

  Interventional Pain Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1407813660
  Care Compare affiliation
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1467512624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2240",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917882240",
            "telephone_number": "909-593-1002",
            "fax_number": "909-593-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W BONITA AVE",
            "address_2": "SUITE 160",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671863",
            "telephone_number": "909-593-1002",
            "fax_number": "909-593-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12442 Limonite Ave Unit 211",
            "address_purpose": "LOCATION",
            "city": "Eastvale",
            "state": "CA",
            "postal_code": "917522467",
            "country_code": "US",
            "telephone_number": "909-593-1002",
            "fax_number": "909-593-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRYAN",
        "middle_name": "XIAO-QIU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A91137",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A91137",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A91137",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A91137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee & Widodo DDS Inc
• Aaron Jordan Lee
• Alexander Lee, DMD
• Brittney Lee, LCSW
• Bryan Lee
• Daniel Lee
• Daniel Lee
• Daniel Lee
• Eunice Lee
• Ivan Lee

• Interventional Pain Medicine Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.