Individual provider Active NPI

Myunghee Rachael Lee

  • Physician Assistant
  • Chula Vista, CA
National Provider Identifier
1942914510
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61725 Issued in CA
Practice address
340 4TH Ave Ste 7a
Chula Vista, CA 91910-3813
Phone
(619) 691-0388
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 61725 CA Primary

Addresses

Primary practice location

340 4TH Ave Ste 7a
Chula Vista, CA 91910-3813

Mailing address

340 4TH Ave Ste 7a
Chula Vista, CA 91910-3813
Phone (619) 691-0388

Other practice location 1

530 Lomas Santa Fe Dr Ste 8
Solana Beach, CA 92075-1350
Phone (858) 704-4151

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230202001561 CA Practitioner - Physician Assistant 0244602183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

3955 Bonita Rd
Bonita, CA 91902-1230
Phone (619) 528-5000

400 Craven Rd
San Marcos, CA 92078-4201
Phone (619) 528-5000

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61725CAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 20, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 20, 2024 Accepting new patients

Locations

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

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Interoperability endpoints

  • Direct secure messaging: mlee32456@sharphealthcare.direct-ci.com

Organizations & group practices 4

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1942914510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 4TH AVE STE 7A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-691-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 4TH AVE STE 7A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-691-0388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Lomas Santa Fe Dr Ste 8",
            "address_purpose": "LOCATION",
            "city": "Solana Beach",
            "state": "CA",
            "postal_code": "920751350",
            "country_code": "US",
            "telephone_number": "858-704-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYUNGHEE",
        "middle_name": "RACHAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61725",
            "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": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.