Individual provider Active NPI

Jennifer G. Lee, M.D.

  • Emergency Medicine Physician
  • Kailua, HI
National Provider Identifier
1760864664
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-20296 Issued in HI
Practice address
640 Ulukahiki St
Kailua, HI 96734-4454
Phone
(808) 263-5164
NPI assigned
Jun 26, 2015
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-20296 HI Primary

Addresses

Primary practice location

640 Ulukahiki St
Kailua, HI 96734-4454

Mailing address

407 Uluniu St Ste 411
Kailua, HI 96734-2544
Phone (808) 261-3326

Other practice location 1

1000 W Carson St
Torrance, CA 90502-2004
Phone (310) 222-3501

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220325002076 CA Practitioner - Emergency Medicine 6406187517 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HMH Emergency Medical Group, Inc.Group PAC ID 7911800826, 56 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone 6264470296142

1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.41 of 100Reported as group
Quality
79.31
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-20296HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 24, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 24, 2023 Accepting new patients
HMH Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jul 26, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients
Huntington Memorial Hospital Past Accepting new patients

Locations

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

Interoperability endpoints

  • Direct secure messaging: jlee498698@direct.cshs.org

Organizations & group practices 7

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 2

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1760864664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 411",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544",
            "telephone_number": "808-261-3326",
            "fax_number": "808-261-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ULUKAHIKI ST",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344454",
            "telephone_number": "808-263-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-3501",
            "fax_number": "310-782-1763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIFER",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2023-01-13",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD-20296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.