Active NPI
Jessica J. Lee, MD
- Nephrology Physician
- San Diego, CA
National Provider Identifier
1710067616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 0101240213
- Practice address
- 34800 Bob Wilson Dr
Nephrology Clinic
San Diego, CA 92134-1098 - Phone
- (619) 532-8840
- Fax
- (619) 532-7178
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101240213 | VA | |
| Nephrology Physician | 207RN0300X | 0101240213 | VA | Primary |
Addresses
Primary practice location
34800 Bob Wilson Dr
Nephrology Clinic
San Diego, CA 92134-1098
Mailing address
34800 Bob Wilson Drive
Nmcsd Nephrology
San Diego, CA 92134
Phone (619) 532-8840
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140415000780 | CA | Order and Referring Only - Nephrology | 0345472874 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101240213 | VA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1710067616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DRIVE",
"address_2": "NMCSD NEPHROLOGY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92134",
"telephone_number": "619-532-8840",
"fax_number": "619-532-7178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"address_2": "NEPHROLOGY CLINIC",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-8840",
"fax_number": "619-532-7178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JESSICA",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2023-03-09",
"certification_date": "2023-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101240213",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "VA",
"license": "0101240213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.