Paul Lee, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

165295 Issued in CA

Practice address

12550 Hesperia Rd Ste 100
Victorville, CA 92395-5873

Phone

(760) 241-6666

NPI assigned

Jun 15, 2016

Last updated

Nov 5, 2021By 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 1

Addresses

Electronic endpoints 1

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

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health High Desert Home health agency, Hesperia, CA, CCN 059315

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• St. Mary Medical Center

  dba Providence St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  NPD (past)

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

• St. Mary High Desert Home Health Services, LLC

  dba Providence Home Health High Desert

  • Home Health Agency
  • Hesperia, CA
  • NPI 1437484409
  Care Compare affiliation

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1497105951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA RD STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955873",
            "telephone_number": "760-241-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA RD STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955873",
            "telephone_number": "760-241-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "165295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "plee1373332@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12550 Hesperia Rd Ste 100",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923955873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Myung Lee, MD
• Kevin Patrick Lee
• Kevin Seokjong Lee, DDS
• Micah Lee
• Ouida She' Lee
• Sameisha Dishanei Lee
• Thomas Kan Lee, OD
• Yonghee Lee, DDS
• Legacy Valley Addiction Treatment
• Maricela Leiker

• Family Medicine Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.