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KEVIN LEE
NPI 1063255560
Nurse Practitioner - Psychiatric/Mental Health in Los Angeles, CA

Active since June 13, 2024PECOS Enrolled
1906 S PALM GROVE AVE, LOS ANGELES, CA 90016(571) 451-7470 Get Directions Write a Review

NPPES record last updated: February 3, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 3, 2026, Jan 30, 2026, Sep 8, 2025 and 1 more (4 updates tracked since 2024).

About Kevin Lee NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN LEE (NPI 1063255560) is an individual psychiatric/mental health provider in Los Angeles, California, licensed in California (95034991) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1063255560
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameKEVIN LEE
Location Address1906 S PALM GROVE AVELos Angeles, CA 90016-1630
Mailing Address1906 S Palm Grove AveLos Angeles, CA 90016-1630 · (571) 451-7470
Phone(571) 451-7470
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJune 13, 2024
Last NPPES UpdateFebruary 3, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2026
✔ NPI 1063255560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95034991
1906 S PALM GROVE AVE, Los Angeles, CA 90016
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11113 Alta Ave Ste 106Upland, CA 91786-2803 · Phone (909) 353-2947 · Fax (909) 232-9041
Location 22409 N Sepulveda Blvd Ste 205Manhattan Beach, CA 90266-2946 · Phone (909) 353-2947 · Fax (909) 232-9041

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Lee is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294214276
PECOS Enrollment IDI20260210001554
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kevin Lee reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sameer Sunita Hassamal & Company, Apc
41 mi
Psychiatry
1113 ALTA AVE STE 106
Upland, CA 91786
  • Reassigned Medicare billing, California enrollment
  • 4 clinicians in this Medicare group
NPI 1710691431 (909) 638-2475

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Lee's NPI number?

The NPI number for Kevin Lee is 1063255560. It was assigned to this individual provider in the NPPES registry on June 13, 2024.

Where is Kevin Lee located?

Kevin Lee practices at 1906 S Palm Grove Ave, Los Angeles, CA 90016. The listed phone number is (571) 451-7470.

What is Kevin Lee's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kevin Lee enrolled in Medicare?

Yes. Kevin Lee is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kevin Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Lee reassigns Medicare benefits to Sameer Sunita Hassamal & Company, Apc (Upland, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Lee's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kevin Lee was last updated on February 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.