Individual provider Active NPI

Lidia Yu Mi Lee, PA-C

  • Physician Assistant
  • Torrance, CA
National Provider Identifier
1740814219
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58192 Issued in CA
Practice address
5215 Torrance Blvd Ste 300
Torrance, CA 90503-4009
Phone
(424) 212-5361
Fax
(310) 316-3466
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 58192 CA Primary

Addresses

Primary practice location

5215 Torrance Blvd Ste 300
Torrance, CA 90503-4009

Mailing address

PO Box 74267
Los Angeles, CA 90004-0267

Other practice location 1

949 S Manhattan Pl Apt 204
Los Angeles, CA 90019-2363
Phone (310) 387-2822

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027003138 CA Practitioner - Physician Assistant 9830509165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

2336 Santa Monica Blvd
Suite 204
Santa Monica, CA 90404-2938
Phone (310) 829-6789

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 540-7676

Hospital & facility affiliations

  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58192CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint John'S Health Clinic Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1740814219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74267",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900040267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 TORRANCE BLVD STE 300",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034009",
            "telephone_number": "424-212-5361",
            "fax_number": "310-316-3466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "949 S Manhattan Pl Apt 204",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900192363",
            "country_code": "US",
            "telephone_number": "310-387-2822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "LIDIA",
        "middle_name": "YU MI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.