Edward Wan-Jae Lee, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A106255 Issued in CA

Practice address

3055 Wilshire Blvd Ste 100
Los Angeles, CA 90010-1119

Phone

(213) 484-1000

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Specialty

Ophthalmology

Education

Northwestern University Feinberg Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Steven G Khwarg MD Prof CorpGroup PAC ID 6002083243, 3 clinicians

Serrano Eye Center Medical GroupGroup PAC ID 8224117403, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: eleemd@serranoeyecenter.direct.eyemdemr.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.

• Serrano Eye Center Medical Group

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1851332241
  Medicare reassignment Care Compare group NPD
• Steven G Khwarg MD Prof Corp

  • Retina Specialist (Ophthalmology) Physician
  • Los Angeles, CA
  • NPI 1568722957
  Medicare reassignment Care Compare group
• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1376595777
  NPD (past)
• Steven G Khwarg M D Prof Corp

  • Ambulatory Surgical Clinic/Center
  • Los Angeles, CA
  • NPI 1245367051
  NPD (past)
• Tarzana Medical Center LLC

  • General Acute Care Hospital
  • Tarzana, CA
  • NPI 1821250762
  NPD (past)
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD (past)
• Hennepin Healthcare System, Inc

  • Rehabilitation Hospital Unit
  • Minneapolis, MN
  • NPI 1033138136
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1487866588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101119",
            "telephone_number": "213-484-1000",
            "fax_number": "213-484-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101119",
            "telephone_number": "213-484-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EDWARD",
        "middle_name": "WAN-JAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "49176",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A106255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIV. PTAN",
            "identifier": "CC083Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "W2067",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dwight Kenneth Lee, MD
• Edward Lee, PHARMD
• Edward Lee, DDS
• Edward S Lee, MD, MPH
• Edward Sang Joon Lee, M.D.
• Edward Wolfgang Lee, MD
• Edwin Aik Meng Lee, MD
• Elinor Lee, MD
• Elisa Lee, PHARM.D.
• Elissa Lee

• Ophthalmology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.