Individual provider Active NPI

Brandon Lee, DO

  • Emergency Medicine Physician
  • Joint Base Lewis McChord, WA
National Provider Identifier
1649695248
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A16787 Issued in CA
Practice address
9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone
(253) 968-1511
NPI assigned
Feb 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A16787 CA Primary

Addresses

Primary practice location

9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000

Mailing address

9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-1511

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190424003315 CA Practitioner - Emergency Medicine 6406198316 Reassigns benefits to 2 organizations
I20210804002073 TX Practitioner - Emergency Medicine 6406198316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.2 of 100Reported as group
Quality
74.9
Improvement activities
40
Cost
20.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 21, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 21, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jul 20, 2021 Accepting new patients

Locations

12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1649695248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 FITZSIMMONS DR",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 FITZSIMMONS DR",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRANDON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A16787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Joint Base Lewis McChord, WA

Sources for this page

Verify at the official NPI Registry.