Individual provider Active NPI

Verlicia Catherine Lee, PA-C

  • Physician Assistant
  • Santa Ana, CA
National Provider Identifier
1497212252
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56501 Issued in CA
Practice address
1212 W 17TH St
Santa Ana, CA 92706-3418
Phone
(714) 954-0432
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56501 CA Primary

Addresses

Primary practice location

1212 W 17TH St
Santa Ana, CA 92706-3418

Mailing address

1212 W 17TH St
Santa Ana, CA 92706-3418
Phone (714) 954-0432

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624001301 CA Practitioner - Physician Assistant 9537493614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

11420 Warner Ave
Fountain Valley, CA 92708-2529
Phone (714) 549-1300

1212 W 17TH St
Santa Ana, CA 92706-3418
Phone (714) 954-0432

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56501CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Park Medical Group, Inc Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1497212252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418",
            "telephone_number": "714-954-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418",
            "telephone_number": "714-954-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "VERLICIA",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.