Individual provider Active NPI

Gary Stewart Lee, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Fremont, CA
National Provider Identifier
1710943113
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
G61379 Issued in CA
Practice address
42808 Christy St Ste 216
Fremont, CA 94538-3119
Phone
(408) 900-8838
Fax
(408) 962-0235
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G61379 CA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X G61379 CA Primary

Addresses

Primary practice location

42808 Christy St Ste 216
Fremont, CA 94538-3119

Mailing address

PO Box 6792
San Jose, CA 95150-6792
Phone (408) 657-3623

Other identifiers 1

IdentifierTypeStateIssuer
00G613790MedicaidCA

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
I20090129000096 CA Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 8729142260 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine, Hospice/Palliative Care
Education
University of California, San Diego School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G61379CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Aug 1, 1990 Accepting new patients
County of Santa Clara CurrentSince Aug 1, 1990 Accepting new patients
County of Santa Clara CurrentSince Nov 27, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Internal Medicine Current Accepting new patients
County of Santa Clara CurrentSince Nov 27, 2018 Accepting new patients
Suncrest Hospice San Jose LLC Past Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

751 S Bascom Ave
Fl 3
San Jose, CA 95128
Phone (408) 358-2511

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1650 Las Plumas Ave
Ste K
San Jose, CA 95133
Phone (408) 272-6726

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: glee10974@santaclaravalley.direct-ci.net

Organizations & group practices 8

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 1

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1710943113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6792",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951506792",
            "telephone_number": "408-657-3623",
            "fax_number": "888-787-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42808 CHRISTY ST STE 216",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945383119",
            "telephone_number": "408-900-8838",
            "fax_number": "408-962-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GARY",
        "middle_name": "STEWART",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G61379",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G61379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G613790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.