Angela Renee Lee, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA14169 Issued in CA

Practice address

1009 N Avalon Blvd
Wilmington, CA 90744-4505

Phone

(310) 549-5760

Fax

(310) 549-2277

NPI assigned

Mar 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilmington Community ClinicGroup PAC ID 2567506504, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: alee660434@direct.ochin.org

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.

• Wilmington Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Wilmington, CA
  • NPI 1932194586
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1821269135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444505",
            "telephone_number": "310-549-5760",
            "fax_number": "310-549-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444505",
            "telephone_number": "310-549-5760",
            "fax_number": "310-549-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alee@wilmingtoncc.org",
            "affiliation": "N",
            "address_1": "1009 N Avalon Blvd",
            "city": "Wilmington",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907444505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marilyn Kleist, LMFT
• Krynen Chiropractic Inc
• Paul J Krynen, D.C.
• Antoinette Laura, NP
• Benjamin Bao Le, DMD
• Samuel Lee
• Lee&Lee Therapy Inc
• Lemus Marriage and Family Counseling PC
• Evelin Lemus
• Tiffany M Lewis, LVN

• Medical Physician Assistant in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.