NPIMap

Individual provider Active NPI

David Jin Lee, D.O.

  • Family Medicine Physician
  • La Canada, CA
National Provider Identifier
1699016980
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A14782 Issued in CA
Practice address
1975 Verdugo Blvd Ste B
La Canada, CA 91011-3024
Phone
(818) 541-1134
Fax
(818) 249-9420
NPI assigned
Mar 12, 2013
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A14782 CA Primary

Addresses

Primary practice location

1975 Verdugo Blvd Ste B
La Canada, CA 91011-3024

Mailing address

1975 Verdugo Blvd Ste B
La Canada, CA 91011-3024
Phone (818) 541-1134

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160831002322 CA Practitioner - Family Practice 5991937237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 Congress St
Suite 208
Pasadena, CA 91105-3027
Phone (626) 792-2166

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
87.72
Promoting interoperability
96
Improvement activities
40
Cost
74.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14782CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Huntington Medical Foundation Family Medicine CurrentSince Jul 15, 2021 Accepting new patients
The Health Care Authority of the City of Anniston Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients
Huntington Medical Foundation Family Medicine Past Accepting new patients
First Choice Urgent Care PC PastSince Jul 1, 2015 Accepting new patients

Locations

10 Congress St
Ste 208
Pasadena, CA 91105
Phone (626) 792-2166

65 N Madison Ave
Ste 800
Pasadena, CA 91101
Phone (626) 792-3141

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dlee432450@direct.cshs.org
  • FHIR API: https://api.platform.athenahealth.com/15682/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 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": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1699016980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 VERDUGO BLVD STE B",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910113024",
            "telephone_number": "818-541-1134",
            "fax_number": "818-249-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 VERDUGO BLVD STE B",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910113024",
            "telephone_number": "818-541-1134",
            "fax_number": "818-249-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAVID",
        "middle_name": "JIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-12",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

Verify at the official NPI Registry.