Individual provider Active NPI

Patrick Kevin Lee, M.D.

  • MOHS-Micrographic Surgery Physician
  • Tustin, CA
National Provider Identifier
1679566335
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
G74804 Issued in CA
Practice address
13420 Newport Ave
Suite G
Tustin, CA 92780-3745
Phone
(714) 731-0061
Fax
(714) 731-0164
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X G74804 CA Primary
Dermatology Physician 207N00000X G74804 CA

Addresses

Primary practice location

13420 Newport Ave
Suite G
Tustin, CA 92780-3745

Mailing address

13420 Newport Ave
Suite G
Tustin, CA 92780-3745
Phone (714) 731-0061

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506000758 CA Practitioner - Dermatology 9830227131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uci Department of DermatologyGroup PAC ID 7113920992, 38 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision82
Removal of skin lesions620
Removal of skin cancer291
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy139

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uci Department of Dermatology Dermatology CurrentSince Sep 1, 2012 Accepting new patients
University of California Irvine Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1640 Newport Blvd
Ste 240
Costa Mesa, CA 92627
Phone (949) 999-2411

850 Health Sciences Rd
Fl 2
Irvine, CA 92617
Phone (602) 614-8874

101 The City Dr S
Bldg 1
Orange, CA 92868
Phone (714) 456-2911

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

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 2

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": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1679566335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13420 NEWPORT AVE",
            "address_2": "SUITE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803745",
            "telephone_number": "714-731-0061",
            "fax_number": "714-731-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13420 NEWPORT AVE",
            "address_2": "SUITE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803745",
            "telephone_number": "714-731-0061",
            "fax_number": "714-731-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PATRICK",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G74804",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G74804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.