Individual provider Active NPI

Thomas T Lee, MD

  • Anesthesiology Physician
  • Santa Ana, CA
National Provider Identifier
1770569188
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A66085 Issued in CA
Practice address
1001 N Tustin Ave
Santa Ana, CA 92705-3502
Phone
(714) 953-3500
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9775 NV
Anesthesiology Physician 207L00000X A66085 CA Primary

Addresses

Primary practice location

1001 N Tustin Ave
Santa Ana, CA 92705-3502

Mailing address

PO Box 1809
Orange, CA 92856-0809
Phone (714) 560-1580

Other identifiers 1

IdentifierTypeStateIssuer
002018473MedicaidNV

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
I20150730013195 CA Practitioner - Anesthesiology 1557455706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66085CAMDAnesthesiology Physician
9775NVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jade Phoenix Aesthetic Medicine, PC Current Accepting new patients
Dodd Hyer, M.D. LTD Anesthesiology Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1770569188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1809",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928560809",
            "telephone_number": "714-560-1580",
            "fax_number": "714-560-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053502",
            "telephone_number": "714-953-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "THOMAS",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "9775",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A66085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018473",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.