Individual provider Active NPI

Kristen M Lee, PA

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1649216789
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118247 Issued in FL
Practice address
1312 Manatee Ave E
Bradenton, FL 34208-1358
Phone
(941) 708-8700
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085004658 IL
Physician Assistant 363A00000X PA9118247 FL Primary
Physician Assistant 363A00000X 085004658 IL

Addresses

Primary practice location

1312 Manatee Ave E
Bradenton, FL 34208-1358

Mailing address

PO Box 9727
Peoria, IL 61612-9727
Phone (309) 886-9172

Other practice location 1

256 S Soangetaha Rd
Galesburg, IL 61401-5586
Phone (309) 233-2836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20130828000505 IL Practitioner - Physician Assistant 0749285476 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solvera Healthcare Center IncGroup PAC ID 4981007226, shared by 4 NPIs, 8 clinicians

Practice addresses (Care Compare)

256 S Soangetaha Rd
Galesburg, IL 61401-5586
Phone (309) 233-2836

3525 N University St
Peoria, IL 61604-1324
Phone (309) 886-9172

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
62.57
Promoting interoperability
100
Improvement activities
40
Cost
77.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9118247FLMDPhysician Assistant
085004658ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Solvera Healthcare Center Inc CurrentSince Jul 22, 2024 Accepting new patients
Solvera Healthcare Center Inc CurrentSince Jul 22, 2024 Accepting new patients
Solvera Healthcare Center Inc CurrentSince Jul 22, 2024 Accepting new patients
Graham Hospital Association CurrentSince Aug 1, 2022 Accepting new patients
Emergency Care Specialists PC Past Accepting new patients
Hastings Emergency Physicians PLC Medical Past Accepting new patients

Locations

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

256 S Soangetaha Rd
Galesburg, IL 61401
Phone (309) 233-2836

3525 N University St
Peoria, IL 61604
Phone (309) 886-9172

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1649216789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9727",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616129727",
            "telephone_number": "309-886-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 MANATEE AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081358",
            "telephone_number": "941-708-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 S Soangetaha Rd",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614015586",
            "country_code": "US",
            "telephone_number": "309-233-2836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004658",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118247",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.