Active NPI
Kendrick E. Lee, MD
- Orthopaedic Hand Surgery Physician
- Oakland, CA
National Provider Identifier
1508833377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- G62668
- Practice address
- 3315 Broadway
Oakland, CA 94611-5717 - Phone
- (510) 486-2300
- Fax
- (510) 486-2333
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | G62668 | CA | Primary |
Addresses
Primary practice location
3315 Broadway
Oakland, CA 94611-5717
Mailing address
200 Porter Dr
Suite 101
San Ramon, CA 94583-1587
Phone (925) 838-1440
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G626680 | Medicaid | CA | |
| 200018919 | Other | CA | RAIL ROAD MEDICARE |
| 00G626680 | Other | CA | BLUE SHIELD |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081016000446 | CA | Practitioner - Hand Surgery | 9830196088 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62668 | CA | MD | General Practice Dentistry |
| G62668 | CA | MD | Orthopaedic Hand Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Webster Orthopaedic Medical Group, a Professional Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- San Ramon, CA
- NPI 1598732984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1508833377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 PORTER DR",
"address_2": "SUITE 101",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945831587",
"telephone_number": "925-838-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3315 BROADWAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115717",
"telephone_number": "510-486-2300",
"fax_number": "510-486-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KENDRICK",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "CA",
"license": "G62668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G626680",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "200018919",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G626680",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.