Individual provider Active NPI

Patrick J Lee

  • Physician Assistant
  • Lake Grove, NY
National Provider Identifier
1861275596
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030409 Issued in NY
Practice address
12 English Ivy LN
Lake Grove, NY 11755-1847
Phone
(559) 321-3873
NPI assigned
Aug 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 030409 NY Primary

Addresses

Primary practice location

12 English Ivy LN
Lake Grove, NY 11755-1847

Mailing address

12 English Ivy LN
Lake Grove, NY 11755-1847
Phone (559) 321-3873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241209002578 NY Practitioner - Physician Assistant 1052847431 Reassigns benefits to 1 organization
I20251007003059 CA Practitioner - Physician Assistant 1052847431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps Health Inpatient Providers Medical Group IncGroup PAC ID 9436314762, 209 clinicians

Practice addresses (Care Compare)

435 H St
Chula Vista, CA 91910-4307
Phone (619) 691-7000

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

Hospital & facility affiliations

  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Inpatient Providers Medical Group Inc. CurrentSince Sep 1, 2025 Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

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.

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1861275596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ENGLISH IVY LN",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551847",
            "telephone_number": "559-321-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ENGLISH IVY LN",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551847",
            "telephone_number": "559-321-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PATRICK",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.