1. Home
  2. Directory
  3. California
  4. Ontario
  5. Nurse Practitioner
  6. NPI Profile

GRACE K. LEE FNP-C
NPI 1104683283
Nurse Practitioner - Family in Ontario, CA

Active since March 05, 2024PECOS Enrolled
3990 CONCOURS STE 500, ONTARIO, CA 91764(909) 605-8000 Get Directions Write a Review

NPPES record last updated: November 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 22, 2025, Mar 5, 2024 (2 updates tracked since 2024).

About Grace K. Lee Fnp-c NPPES

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

GRACE K. LEE FNP-C (NPI 1104683283) is an individual family provider in Ontario, California, licensed in California (95027005) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104683283
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameGRACE K. LEECredential: FNP-C
Location Address3990 CONCOURS STE 500Ontario, CA 91764-7983
Mailing AddressPo Box 35380Las Vegas, NV 89133-5380 · (702) 579-3203
Phone(909) 605-8000
Sole ProprietorNo
Enumeration DateMarch 5, 2024
Last NPPES UpdateNovember 22, 20252 updates tracked since enumeration
NPPES CertifiedNovember 22, 2025
✔ NPI 1104683283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95027005
3990 CONCOURS STE 500, Ontario, CA 91764
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace K. Lee Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Grace Lee reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Beaver Medical Group P C
22 mi
Family Medicine
2 WEST FERN AVENUE
Redlands, CA 92373
  • Reassigned Medicare billing, California enrollment
  • 635 clinicians in this Medicare group
NPI 1649503319 (909) 793-3311
Healthcare Partners Affiliates Medical Group
28 mi
Addiction Medicine
14591 NEWPORT AVE
Tustin, CA 92780
  • Reassigned Medicare billing, California enrollment
  • 2,052 clinicians in this Medicare group
NPI 1891981502 (714) 442-4864

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 91764 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIM LA TA PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3990 CONCOURS STE 500
ONTARIO, CA 91764
San Bernardino County (909) 605-8000
MRS. HANNA CHOI PHYSICIAN ASSISTANT
Physician Assistant
3990 CONCOURS STE 500
ONTARIO, CA 91764
San Bernardino County (909) 731-7951
SARU SACHDEVA M.D.
Internal Medicine (Rheumatology)
3990 CONCOURS STE 500
ONTARIO, CA 91764
San Bernardino County (909) 605-8000

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 Grace Lee's NPI number?

The NPI number for Grace Lee is 1104683283. It was assigned to this individual provider in the NPPES registry on March 5, 2024.

Where is Grace Lee located?

Grace Lee practices at 3990 Concours Ste 500, Ontario, CA 91764. The listed phone number is (909) 605-8000.

What is Grace Lee's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Grace Lee enrolled in Medicare?

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

Which organizations bill Medicare for Grace Lee's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Grace Lee reassigns Medicare benefits to 2 organizations: Beaver Medical Group P C (Redlands, CA) and Healthcare Partners Affiliates Medical Group (Tustin, CA). Each 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 Grace 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 Grace Lee was last updated on November 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.