Individual provider Active NPI

Maria Kehaulani Lee, DPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1821616475
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31298 Issued in AZ
Practice address
4344 W Bell Rd
Glendale, AZ 85308-3589
Phone
(602) 548-9882
Fax
(602) 548-0228
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-31298 AZ Primary

Addresses

Primary practice location

4344 W Bell Rd
Glendale, AZ 85308-3589

Mailing address

N5654 State Highway 54
Black River Falls, WI 54615-5919
Phone (715) 299-6533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210618001869 AZ Practitioner - Physical Therapist in Private Practice 5991105587 Reassigns benefits to 1 organization
I20251105000362 WI Practitioner - Physical Therapist in Private Practice 5991105587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

478 W Arndt St
Fond Du Lac, WI 54935-2109
Phone (920) 933-6304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31298AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Sep 13, 2023 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Oct 9, 2025 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Oct 9, 2025 Accepting new patients
Adaptive Rehabilitation Clinics, LLC Physical Therapist Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
BHSM Rehabilitation, LLC PastSince Jul 12, 2020 Accepting new patients

Locations

478 W Arndt St
Fond du Lac, WI 54935
Phone (920) 933-6304

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

Organizations & group practices 6

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": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1821616475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5654 STATE HIGHWAY 54",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155919",
            "telephone_number": "715-299-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083589",
            "telephone_number": "602-548-9882",
            "fax_number": "602-548-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARIA",
        "middle_name": "KEHAULANI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.