Individual provider Active NPI

Jason P Lee, MD

  • Psychiatry Physician
  • Sylmar, CA
National Provider Identifier
1487188629
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A157810 Issued in CA
Practice address
14445 Olive View Dr # H1
Sylmar, CA 91342-1437
Phone
(949) 246-9750
NPI assigned
Apr 14, 2017
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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 CA
Specialist 174400000X A157810 CA
Psychiatry Physician 2084P0800X A157810 CA Primary

Addresses

Primary practice location

14445 Olive View Dr # H1
Sylmar, CA 91342-1437

Mailing address

14860 Roscoe Blvd Ste 304
Panorama City, CA 91402-4695
Phone (949) 246-9750

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181214002823 CA Practitioner - Psychiatry 3870838147 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Drexel University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Medical Solutions Inc a Medical GroupGroup PAC ID 5294783080, 37 clinicians

Practice addresses (Care Compare)

14850 Roscoe Blvd
Panorama City, CA 91402-4618
Phone (310) 553-5203

8920 Wilshire Blvd
Suite 310
Beverly Hills, CA 90211-2003
Phone (310) 553-5203

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157810CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
KLC Consultants, PC Psychiatry CurrentSince Mar 1, 2022 Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Oct 15, 2018 Accepting new patients
JPL Mental Health Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
County of Los Angeles CurrentSince Oct 15, 2018 Accepting new patients
Gateways Hospital & Mental Health Center CurrentSince May 2, 2024 Accepting new patients
County of Los Angeles Current Accepting new patients
Innovative Medical Solutions Inc a Medical Group CurrentSince May 21, 2022 Accepting new patients

Locations

30101 Agoura Ct
Ste 100
Agoura Hills, CA 91301
Phone (818) 879-9018

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

1891 Effie St
Los Angeles, CA 90026

14860 Roscoe Blvd
Ste 200
Panorama City, CA 91402
Phone (818) 830-7751

14860 Roscoe Blvd
Ste 304
Panorama City, CA 91402
Phone (747) 998-0387

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

14445 Olive View Dr
#H1
Sylmar, CA 91342
Phone (747) 210-3343

Organizations & group practices 7

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 1

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1487188629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14860 ROSCOE BLVD STE 304",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024695",
            "telephone_number": "949-246-9750",
            "fax_number": "906-254-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR # H1",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "949-246-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A157810",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A157810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.