Individual provider Active NPI

Kiana Lee, PA-C

  • Medical Physician Assistant
  • Daly City, CA
National Provider Identifier
1558070821
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA62142 Issued in CA
Practice address
211 Eastmoor Ave
Daly City, CA 94015-2036
Phone
(650) 550-3923
NPI assigned
Nov 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA62142 CA Primary

Addresses

Primary practice location

211 Eastmoor Ave
Daly City, CA 94015-2036

Mailing address

211 Eastmoor Ave
Daly City, CA 94015-2036

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
I20230224000405 CA Practitioner - Physician Assistant 3678946522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North East Medical ServicesGroup PAC ID 4284520529, 143 clinicians

Practice addresses (Care Compare)

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

211 Eastmoor Ave
Daly City, CA 94015-2036
Phone (415) 391-9686

2574 San Bruno Ave
San Francisco, CA 94134-1505
Phone (415) 391-9686

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62142CAMDDentist
PA62142CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince Mar 20, 2023 Accepting new patients
North East Medical Services CurrentSince Mar 20, 2023 Accepting new patients
North East Medical Services Past Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

1850 Sullivan Ave
Ste 150
Daly City, CA 94015
Phone (650) 991-5880

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Interoperability endpoints

  • Direct secure messaging: klee19009@northeastmedicalservicesnems.direct-ci.com

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.

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": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1558070821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EASTMOOR AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EASTMOOR AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152036",
            "telephone_number": "650-550-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA62142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.