Individual provider Active NPI

Carolyn Lee, MSPT

  • Orthopedic Physical Therapist
  • San Francisco, CA
National Provider Identifier
1700805462
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT25077 Issued in CA
Practice address
2191 Market Street
Suite C
San Francisco, CA 94114-1399
Phone
(415) 861-1856
Fax
(415) 839-8294
NPI assigned
Jul 19, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25077 CA
Orthopedic Physical Therapist 2251X0800X PT25077 CA Primary

Addresses

Primary practice location

2191 Market Street
Suite C
San Francisco, CA 94114-1399

Mailing address

2191 Market Street
Suite C
San Francisco, CA 94114-1399
Phone (415) 861-1856

Other names 1

  • Carrie Lee Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120828000634 CA Practitioner - Physical Therapist in Private Practice 1153578026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agile Physical Therapy IncGroup PAC ID 2163311556, 48 clinicians

Practice addresses (Care Compare)

3825 El Camino Real
Palo Alto, CA 94306-3324
Phone (650) 565-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT25077CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agile Physical Therapy Inc CurrentSince Aug 22, 2020 Accepting new patients
Marin Sport and Spine Physical Therapy Physical Therapist PastSince Jul 21, 2012 Accepting new patients
Jay West Physical Therapy Inc Physical Therapist PastSince Dec 24, 2023 Accepting new patients
Montclair Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

3825 El Camino Real
Palo Alto, CA 94306
Phone (856) 296-2860

100 Bush St
Ste 800
San Francisco, CA 94104
Phone (415) 318-8138

2191 Market St
Ste C
San Francisco, CA 94114
Phone (415) 861-1856

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1700805462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 MARKET STREET",
            "address_2": "SUITE C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141399",
            "telephone_number": "415-861-1856",
            "fax_number": "415-839-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 MARKET STREET",
            "address_2": "SUITE C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141399",
            "telephone_number": "415-861-1856",
            "fax_number": "415-839-8294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CAROLYN",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25077",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT25077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "LEE",
            "credential": "MSPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.