Individual provider Active NPI

Shin Rong Lee, M.D., PH.D.

  • Vascular Surgery Physician
  • Concord, CA
National Provider Identifier
1952789992
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
202759 Issued in CA
Practice address
2350 Pacheco St
Concord, CA 94520-2018
Phone
(925) 676-2600
NPI assigned
May 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 202759 CA Primary

Addresses

Primary practice location

2350 Pacheco St
Concord, CA 94520-2018

Mailing address

2350 Pacheco St
Concord, CA 94520-2018
Phone (925) 676-2600

Other practice location 1

1320 El Capitan Dr Ste 120
Danville, CA 94526-6260
Phone (925) 676-2600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909004385 CA Practitioner - Vascular Surgery 6305130162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Johns Hopkins University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay Cardiovascular and Thoracic Associates IncGroup PAC ID 9032290770, 17 clinicians

Practice addresses (Care Compare)

1320 El Capitan Dr
Suite 120
Danville, CA 94526-6260
Phone (925) 676-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202759CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Cardiovascular and Thoracic Associates Inc. CurrentSince Sep 15, 2025 Accepting new patients
Excelsior Surgery Center CurrentSince Sep 15, 2025 Accepting new patients

Locations

4721 Dallas Ranch Rd
Antioch, CA 94531
Phone (925) 676-2600

1320 El Capitan Dr
Ste 120
Danville, CA 94526
Phone (925) 676-2600

Interoperability endpoints

  • Direct secure messaging: slee253396@direct.bilh.masshiway.net
  • Direct secure messaging: slee188466@ehr.johnmuirhealth.com

Organizations & group practices 2

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1952789992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202018",
            "telephone_number": "925-676-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202018",
            "telephone_number": "925-676-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 El Capitan Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "CA",
            "postal_code": "945266260",
            "country_code": "US",
            "telephone_number": "925-676-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SHIN RONG",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "202759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.