Individual provider Active NPI

Laura Lee, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1598037152
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15143 Issued in TX
Practice address
601 W Terrell Ave
Fort Worth, TX 76104-3243
Phone
(817) 702-3100
Fax
(817) 702-4847
NPI assigned
Jan 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 7034950001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7047150001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7629170001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7046960001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7045160001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7057360001 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 7209350001 AZ
Physician Assistant 363A00000X 5018 AZ
Physician Assistant 363A00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA15143 TX Primary

Addresses

Primary practice location

601 W Terrell Ave
Fort Worth, TX 76104-3243

Mailing address

1839 S Alma School Rd Ste 354
Mesa, AZ 85210-3028
Phone (480) 726-2287

Other practice location 1

20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282
Phone (480) 563-1144

Other practice location 2

3011 S Lindsay Rd Ste 101
Gilbert, AZ 85295-4333
Phone (480) 726-2500

Other practice location 3

3130 E Baseline Rd Ste 107
Mesa, AZ 85204-7290
Phone (480) 345-1980

Other practice location 4

15256 N 75th Ave Ste 360
Peoria, AZ 85381-4761
Phone (623) 486-2424

Other practice location 5

270 E Hunt Hwy Ste A-2
San Tan Valley, AZ 85143-4962
Phone (480) 882-2222

Other practice location 6

2145 E Warner Rd Ste 104
Tempe, AZ 85284-3549
Phone (480) 664-9443

Other practice location 7

2 N Central Ave Ste 120
Phoenix, AZ 85004-2972
Phone (602) 296-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121101000398 AZ Practitioner - Physician Assistant 7315197175 Reassigns benefits to 6 organizations
I20211214000221 TX Practitioner - Physician Assistant 7315197175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

601 W Terrell Ave
Fort Worth, TX 76104-3243
Phone (817) 702-3100

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7034950001AZMDDurable Medical Equipment & Medical Supplies
7045160001AZMDDurable Medical Equipment & Medical Supplies
7046960001AZMDDurable Medical Equipment & Medical Supplies
7047150001AZMDDurable Medical Equipment & Medical Supplies
7057360001AZMDDurable Medical Equipment & Medical Supplies
7209350001AZMDDurable Medical Equipment & Medical Supplies
7629170001AZMDDurable Medical Equipment & Medical Supplies

Organizations & group practices 7

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 1

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": "1327795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1598037152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-316-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W TERRELL AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043243",
            "telephone_number": "817-702-3100",
            "fax_number": "817-702-4847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20860 N Tatum Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504282",
            "country_code": "US",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3011 S Lindsay Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852954333",
            "country_code": "US",
            "telephone_number": "480-726-2500",
            "fax_number": "480-726-2131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 E Baseline Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852047290",
            "country_code": "US",
            "telephone_number": "480-345-1980",
            "fax_number": "480-926-1721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15256 N 75th Ave Ste 360",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814761",
            "country_code": "US",
            "telephone_number": "623-486-2424",
            "fax_number": "623-486-4324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "270 E Hunt Hwy Ste A-2",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851434962",
            "country_code": "US",
            "telephone_number": "480-882-2222",
            "fax_number": "480-882-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2145 E Warner Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843549",
            "country_code": "US",
            "telephone_number": "480-664-9443",
            "fax_number": "480-664-9378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 N Central Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042972",
            "country_code": "US",
            "telephone_number": "602-296-4060",
            "fax_number": "602-296-4146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-29",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7034950001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7047150001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7629170001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7046960001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7045160001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7057360001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7209350001",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5018",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.