Individual provider Active NPI

Yong Tai Lee, M.D.

  • Gastroenterology Physician
  • Los Angeles, CA
National Provider Identifier
1972607364
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G67974 Issued in CA
Practice address
903 Crenshaw Blvd Ste 302
Los Angeles, CA 90019-1967
Phone
(323) 731-0681
Fax
(323) 731-0832
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G67974 CA Primary

Addresses

Primary practice location

903 Crenshaw Blvd Ste 302
Los Angeles, CA 90019-1967

Mailing address

903 Crenshaw Blvd Ste 302
Los Angeles, CA 90019-1967
Phone (323) 731-0681

Other identifiers 2

IdentifierTypeStateIssuer
1972607364OtherCANPI
00G679740MedicaidCA

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
I20101025000539 CA Practitioner - Internal MedicinePractitioner - Gastroenterology 4284535089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Loma Linda University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

903 Crenshaw Blvd
Suite 302
Los Angeles, CA 90019-1967
Phone (323) 731-0681

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Upper gastrointestinal (GI) endoscopy for acid reflux53
Varicose vein removal923

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67974CAMDPharmacist
G67974CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Star Ambulatory Surgery Center, Inc. Current Accepting new patients
Yellow Cross Medical Clinic, Inc. CurrentSince Sep 1, 2010 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

120 W Cole Blvd
Ste B
Calexico, CA 92231
Phone (323) 731-0681

903 Crenshaw Blvd
Ste 302
Los Angeles, CA 90019
Phone (323) 731-0681

3544 W Olympic Blvd
Ste 100
Los Angeles, CA 90019
Phone (323) 731-0681

903 Crenshaw Blvd
Ste 200
Los Angeles, CA 90019
Phone (323) 937-3333

3544 W Olympic Blvd
Ste 105
Los Angeles, CA 90019
Phone (323) 731-0681

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1972607364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD STE 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191967",
            "telephone_number": "323-731-0681",
            "fax_number": "323-731-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD STE 302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191967",
            "telephone_number": "323-731-0681",
            "fax_number": "323-731-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YONG",
        "middle_name": "TAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G67974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972607364",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G679740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.