Mark Joon Lee, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22095 Issued in CA

Practice address

420 S Glendora Ave
West Covina, CA 91790-3001

Phone

(562) 928-9600

NPI assigned

Apr 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kevin J Pelton MD IncGroup PAC ID 3375625486, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Kevin J. Pelton MD, Inc.

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
  • NPI 1679771703
  Medicare reassignment Care Compare group NPD
• East Valley Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • West Covina, CA
  • NPI 1831243625
  Medicare reassignment NPD
• Kevin J Pelton MD Inc

  • Durable Medical Equipment & Medical Supplies
  • Glendale, CA
  • NPI 1710764576
  NPD
• Kevin J. Pelton MD, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Santa Fe Springs, CA
  • NPI 1821711870
  NPD (past)
• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  NPD (past)

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1669738225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "562-928-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "562-928-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARK",
        "middle_name": "JOON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gi-Hyung Lee, M.D.
• Hannah Lee
• Ik Sung Danny Lee, DMD
• Jennifer Lee
• John Young Lee, M.D.
• Mike Lee, MS
• Nathan Lee
• Paul Chong Chan Lee, DDS, MS
• Peter Joohak Lee, DDS
• Sabrina Shunhan Lee

• Physician Assistant in West Covina, CA
• Providers in West Covina, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.