Individual provider Active NPI

Steven Seungbin Lee, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1982865267
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A107778 Issued in CA
Practice address
5455 Wilshire Boulevard, Suite 1120
Los Angeles, CA 90036-4201
Phone
(323) 549-3030
Fax
(323) 549-3049
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 232376 NY
Diagnostic Radiology Physician 2085R0202X A107778 CA Primary

Addresses

Primary practice location

5455 Wilshire Boulevard, Suite 1120
Los Angeles, CA 90036-4201

Mailing address

Dept la 21559
Pasadena, CA 91185-1559
Phone (949) 263-8620

Other identifiers 2

IdentifierTypeStateIssuer
1982865267MedicaidCA
00A1077780OtherCABLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20090902000109 CA Practitioner - Diagnostic Radiology 2769537471 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Icahn School of Medicine at Mount Sinai, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

24302 Paseo de Valencia
Laguna Hills, CA 92653-3115
Phone (949) 452-8880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232376NYMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Radiological Medical Group Inc Neuroradiology CurrentSince Aug 27, 2014 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Jan 15, 2018 Accepting new patients
Memorialcare Medical Foundation CurrentSince Jul 1, 2024 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Jan 15, 2018 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Saint John's Tower Imaging Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology PastSince Feb 7, 2018 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24302 Paseo de Valencia
Laguna Hills, CA 92653
Phone (949) 452-8880

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

Dept LA 21591
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: steven.leemd.p105@direct.nautilus.nextgenshare.com

Organizations & group practices 7

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 4

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1982865267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21559",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851559",
            "telephone_number": "949-263-8620",
            "fax_number": "800-409-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BOULEVARD, SUITE 1120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364201",
            "telephone_number": "323-549-3030",
            "fax_number": "323-549-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "STEVEN",
        "middle_name": "SEUNGBIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "232376",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A107778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982865267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A1077780",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.