Individual provider Active NPI

Jacqueline Iris Lee, MD

  • Surgery Physician
  • Stanford, CA
National Provider Identifier
1619137809
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
136691 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 136691 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

PO Box 660599
Dallas, TX 75266-0599
Phone (214) 590-4105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170706003217 HI Practitioner - General SurgeryPractitioner - Other (Physician) 6204149255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State Un of Ny, Stony Brook School of Dental Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Castle Medical CenterGroup PAC ID 6608762778, 77 clinicians

Practice addresses (Care Compare)

640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5142

Hospital & facility affiliations

  • Adventist Health Castle Hospital, Kailua, HI, CCN 120006
  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
  • Kahuku Medical Center Hospital, Kahuku, HI, CCN 121304

Merit-based Incentive Payment System (MIPS)

Final score
84 of 100Reported as group
Quality
84.73
Promoting interoperability
89
Improvement activities
40
Cost
71.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy15
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136691CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Castle Medical Center CurrentSince Jan 1, 2022 Accepting new patients
Castle Medical Center CurrentSince Jan 1, 2022 Accepting new patients
Surgical Associates Inc Surgery CurrentSince Jun 9, 2017 Accepting new patients
Castle Medical Center Current Accepting new patients

Locations

550 S Beretania St
Ste 403
Honolulu, HI 96813
Phone (808) 523-5033

642 Ulukahiki St
Ste 300
Kailua, HI 96734
Phone (808) 261-4166

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

642 Ulukahiki St
Ste 207
Kailua, HI 96734
Phone (808) 261-9931

642 Ulukahiki St
Ste 103
Kailua, HI 96734
Phone (808) 263-5009

Interoperability endpoints

  • Direct secure messaging: jacqueline.lee@10973798596612.direct.elationemr.com

Organizations & group practices 4

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 3

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1619137809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599",
            "telephone_number": "214-590-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JACQUELINE",
        "middle_name": "IRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "136691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.