NPIMap

Individual provider Active NPI

Gloria Lo Lee, MD

  • Internal Medicine Physician
  • Newbury Park, CA
National Provider Identifier
1952394025
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C51138 Issued in CA
Practice address
1000 Newbury Rd Ste 130
Newbury Park, CA 91320-6437
Phone
(805) 214-3122
Fax
(805) 214-3129
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C51138 CA Primary

Addresses

Primary practice location

1000 Newbury Rd Ste 130
Newbury Park, CA 91320-6437

Mailing address

1000 Newbury Rd Ste 130
Newbury Park, CA 91320-6437
Phone (805) 214-3122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000506 CA Practitioner - Internal Medicine 7012965544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prestige Medical Associates, Inc.Group PAC ID 1658549720, 2 clinicians

Practice addresses (Care Compare)

1000 Newbury Rd
Newbury Park, CA 91320-6437
Phone (805) 214-3122

Hospital & facility affiliations

  • Access TLC Home Health Care Home health agency, San Fernando, CA, CCN 058366
  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116
  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51138CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Medical Associates, Inc. Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
Lakeside Medical Organization, a Medical Group Inc. Internal Medicine Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Regal Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

1000 Newbury Rd
Ste 130
Newbury Park, CA 91320
Phone (805) 214-3122

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: gloria.lee.p14@direct.regal.nextgenshare.com

Organizations & group practices 5

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 3

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1952394025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 130",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206437",
            "telephone_number": "805-214-3122",
            "fax_number": "805-214-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 130",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206437",
            "telephone_number": "805-214-3122",
            "fax_number": "805-214-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GLORIA",
        "middle_name": "LO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C51138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newbury Park, CA

Sources for this page

Verify at the official NPI Registry.