NPIMap

Individual provider Active NPI

Edward Lee, MD

  • Internal Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1508863499
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A75527 Issued in CA
Practice address
1665 Scenic Ave
100
Costa Mesa, CA 92626-1445
Phone
(714) 436-4700
Fax
(714) 436-4801
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A75527 CA Primary
Hospitalist Physician 208M00000X A75527 CA

Addresses

Primary practice location

1665 Scenic Ave
100
Costa Mesa, CA 92626-1445

Mailing address

16101 Rockyriver LN
Cerritos, CA 90703-1933
Phone (562) 404-5574

Other practice location 1

100 E Valencia Mesa Dr
Fullerton, CA 92835-3813
Phone (714) 447-5027

Other identifiers 1

IdentifierTypeStateIssuer
00A755270OtherCAMEDI CAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edwardjlee@sjhhandhmg.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000743 CA Practitioner - Internal Medicine 4284695701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75527CAMDHospitalist Physician
75527CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jul 6, 2015 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Talbert Medical Group, P.C. Internal Medicine Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1508863499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 ROCKYRIVER LN",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031933",
            "telephone_number": "562-404-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 SCENIC AVE",
            "address_2": "100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261445",
            "telephone_number": "714-436-4700",
            "fax_number": "714-436-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Valencia Mesa Dr",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353813",
            "country_code": "US",
            "telephone_number": "714-447-5027",
            "fax_number": "714-578-8570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A75527",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A75527",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00A755270",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edwardjlee@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "100 E Valencia Mesa Dr",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.